Steps to take to eliminate spam from your e-mail diet

A practical look at information technology issues and usage

By Pamela Lewis Dolancovered health information technology issues and social media topics affecting physicians. Connect with the columnist: @Plewisdolan  —  Posted April 20, 2009.

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Anyone familiar with e-mail is intimately aware of the annoyances of spam. But experts say that shouldn't be a reason to avoid e-mailing with your patients.

Systems are available to help catch the unwanted messages before they clog your inbox or wreak havoc on your network with attached viruses. Those spam-detecting systems are becoming increasingly effective -- and also increasingly inexpensive.

Bing Liem, DO, advanced cardiovascular specialist at El Camino Hospital in Mountain View, Calif., has been e-mailing patients for several years and has found some of the newest spam filters are among the best he has ever used.

"It seems I only get e-mails from those I want to get e-mails from," Dr. Liem said. He said the risk of spam has been the reason many of his colleagues have chosen not to implement e-mails into their practices.

The first step to fighting spam is reducing your exposure to professional spammers who collect e-mail addresses from various sources.

According to Manhattan Research's 2009 "Taking the Pulse v9.0" survey, 25 million people accessed a physician's Web site last year. Sophisticated spammers use automated systems that comb thousands of Web sites, collecting e-mail addresses to target with spam.

While you need a way for existing and potential patients to contact you, experts say posting your e-mail address on your Web page is a bad idea. Instead, a contact page can be set up on your site where visitors can fill out and submit a form with an attached message that is sent directly to your inbox in the form of an e-mail without your address ever being revealed.

Limiting exposure of your e-mail address can also help reduce your risk. There's no rule against having more than one e-mail address, especially free ones such as through Yahoo or Hotmail. Using those addresses when you're asked for an e-mail address on a form or for a newsletter mailing or listserv, will help protect you in case your e-mail address is ever purchased by a third-party.

Spam can also come disguised as a subscription newsletter. Experts say you should never reply to an unsolicited group e-mail, not even to "unsubscribe." All that will do is tell the spammer your e-mail address is still active.

Once you've trained yourself and your staff how to reduce your exposure to spammers, the next step is putting a system in place to protect yourself from those that do make their way into your network.

Most hospitals and large practices have in-house networks with firewalls and spam filters. These set-ups can cost thousands to install and require a professional IT staff to maintain. But a growing number of practices are looking to so-called cloud computing solutions, which cost very little and can be installed in minutes.

Cloud computing is the use of applications, such as e-mail, that are hosted on the Internet. The biggest difference between using the cloud and other systems is the fact that no hardware, beyond the computer itself, is needed. Unlike other spam filters, the cloud systems catch the suspected spam and quarantine it in the so-called "cloud" before it ever makes it to your e-mail system. Users then access a quarantine file online and decide which e-mails should go to their inbox. Cloud solutions can work with both a network or Web-based e-mail systems.

Sundar Raghavan, vice president of solutions marketing for Postini, a cloud computing provider now owned by Google, said the cloud is more capable than in-house servers of detecting common spam e-mails and viruses because the application is "leveraging thousands and thousands of machines, scaling across thousands and thousands of businesses." This means that the wide-reaching system can detect patterns in e-mails that are sent in vast quantities, indicating they are most likely spam.

Users can also set their own rules for which messages they don't want to see. For example, the word "sex" is found in the subject line of many spam e-mails, so users could create a rule that sends e-mail with "sex" in the subject line directly to quarantine. Specific e-mail addresses can also be set as a rule.

A basic e-mail security system using the cloud averages about $12 per physician per year, using your own e-mail service. Google offers a complete package which includes e-mail service along with the security systems as well as chatting and video functions for about $50 per user, per year. In addition, Microsoft and Yahoo also offer cloud e-mail solutions.

Dr. Liem said he checks his spam file nearly every time he checks his e-mail to make sure legitimate e-mails have not inadvertently been tagged as spam. He said he has never had a patient's e-mail tagged as spam, but he has had e-mails from various listservs to which he subscribes get diverted.

Manhattan Research found that more than 8 million people exchanged e-mails with a physician last year. But with an additional 80% indicating they would like to exchange e-mails with their doctors, it's a good time for those without e-mailing capabilities to consider it. As many practices have found, the threat of spammers doesn't have to be an excuse not to adopt e-mail communication with patients.

Pamela Lewis Dolan covered health information technology issues and social media topics affecting physicians. Connect with the columnist: @Plewisdolan  — 

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