George Mason University

Online Clinical Services


  1. Read Spielberg, Alissa R. JD, MPH, On Call and Online: Socio-historical, Legal, and Ethical Implications of E-mail for the Patient-Physician Relationship Journal of American Medical Association, Volume 280(15) 21 October 1998 pp 1353-1359.  Accession number 00005407-199810210-00033. 
  2. Read Borowitz, Stephen M. MD; Wyatt, Jeremy C. MRCP, DM, FACMI.  The Origin, Content, and Workload of E-mail Consultations. Accession Number 00005407-199810210-00026
  3. Read about online counseling for substance abuse.
  4. Read about Tele-Psychiatry
  5. Griffiths KM, Christensen H.  Quality of web based information on treatment of depression: cross sectional survey.  BMJ. 2000 Dec 16; 321(7275): 1511-1515. PMCID: 27555


The following additional resources are available to help you think through this lecture:

  1. Overview of online counseling (Slides or Narrated  Slides, or SWF file for Firefox browsers )

  2. Online motivational interviewing (Narrated Slides)

  3. Online relapse prevention (Narrated Slides)

  4. Online recovery teams (Narrated Slides)

  5. Online counseling reduces drug use (Slides)

Narrated slides require Flash.

What do you know?

Advanced learners like you, often need different ways of understanding a topic. Reading is just one way of understanding. Another way is through writing. When you write you not only recall what you have written but also may need to make inferences about what you have read. The following questions are  designed to get you to think more about the concepts taught in this session.

1.  Summarize the evidence regarding physicians' use of email. 

2.  Describe the effort it takes to respond with an email?  What takes time, whose time and how long a time.

3. What happened to Toucan?  How long it took to work out technological problems?  Did she relapse?  Was the technology useful after the relapse?

Enter your first name: 

Enter your last name: 

Please send this information to your instructor.

Always remember that one indication of your participation in the class is your active formulation of questions about the lecture topic.  Your questions help your instructor gauge your understanding of the topic.  In addition, they help you get more information.  The answers to your questions are posted on the web, in the lecture in which you asked the question, under the section titled:  Recently Asked Questions.

Project Assignment


Why Plan Emails?

Effective online counseling requires that you think through various types of patients and their potential needs.  Your plans should anticipate that true relationships are built over time and therefore you need to trace the emails you would send your customers over time.  Read the article on involving family members in care of patients, imagine pathways not anticipated and give at least 4 sequenced emails that might be used by the clinician depending on different responses from the clients and their family members.

Make sure the pathway you have imagined is not listed in the reading.

Condition when email is sent: Text of email

Enter your email in the form 

Learn one, teach one

Please read all of the following articles and prepare to discuss them in class.  In addition, volunteer to present one of the following articles to the class.  Email your instructor regarding the article you plan to present.  One of the best ways to master a topic is to teach it.  By presenting one of these articles, you get to have in-depth understanding of the topic. For the article you plan to present, prepare a slide show.  Bring the slides show to the class.  Your presentation will be judged successful to the extent that you can solicit your colleagues comments and input.  

The articles for presentations are the following (remember to Logoff before selecting to see another article otherwise the system will assume you are online and prevent you from signing in again for 15 minutes):

  1. Tate, Deborah F. PhD. Jackvony, Elizabeth H. MPH. Wing, Rena R. PhD. Effects of Internet Behavioral Counseling on Weight Loss in Adults at Risk for Type 2 Diabetes: A Randomized Trial. JAMA. 289(14):1833-1836, April 9, 2003.  Accession Number: 00005407-200304090-00033
  2. Tate DF, Wing RR, Winett RA. Using Internet technology to deliver a behavioral weight loss program. JAMA. 2001;285:1172–1177.   Accession Number: 00005407-200103070-00025
  3. Glasgow RE, Toobert DJ. Brief, computer-assisted diabetes dietary self-management counseling: effects on behavior, physiologic outcomes, and quality of life. Med Care. 2000;38:1062–1073.  Accession Number: 00005650-200011000-00002
  4. Piette, John D. PhD *. Weinberger, Morris PhD +. McPhee, Stephen J. MD ++. The Effect of Automated Calls With Telephone Nurse Follow-Up on Patient-Centered Outcomes of Diabetes Care: A Randomized, Controlled Trial. Medical Care. 38(2):218-230, February 2000.  Accession Number: 00005650-200002000-00011


  1. See what it takes for a clinician to send an email
  2. Administration On Aging
  3. American Academy of Child and Adolescent Psychiatry  
  4. Army's Developmental Counseling 
  5. Association for Death Education and Counseling
  6. Calls to computers treat depression
  7. Clinical Pastoral Education Residency
  8. DoD Caregiver's Guide
  9. Family Matters
  10. Marriage counseling
  11. National Institute on Aging
  12. National Institute on Alcohol Abuse and Alcoholism
  13. National Institute of Child Health and Human Development
  14. National Institute on Drug Abuse
  15. National Substance Abuse Web Index
  16. National Center for Victims of Crime (NCVC)
  17. National Coalition of Homicide Survivors
  18. National Institute on Deafness and Other Communication Disorders
  19. Online doctor offices
  20. Oklahoma City Bombing: A Psychiatrist's Experience
  21. Psych Net, service of American Psychological Association (APA)
  22. Prevention of Youth Violence:
  23. QuitNet, help with quitting smoking
  24. Substance Abuse and Mental Health Services Administration
  25. Suicide and Sudden Loss: Crisis Management in the Schools

  26. Youth Suicide Prevention Programs: A Resource Guide
  27. Family physicians delivers most care by email and phone calls


This page was created by Farrokh Alemi, Ph.D.  Last revised on 10/22/2011.  This page is part of the course on Electronic Commerce and Online Market for Health Services This is the session on Online Clinical Services