Reimbursement issues and privacy concerns rank among the top reasons why only about 7 percent of the more than 4,200 physician practices surveyed by the Center for Studying Health System Change revealed they regularly used email to communicate with patients. All told, however, 65 percent of physicians surveyed said they didn't have any such access to begin with. Despite the correlation that exists between the new meaningful use regulations and email use--namely that electronic medical record use "indirectly encourage[s] email adoption...to the extent electronic messaging tools are integrated or used in conjunction with EMRs"--the report's authors maintain that many doctors remain hesitant because currently, there is no guarantee of money. FierceHealthIT