New Communication Technologies Still Not Taking Off in Medical Practices
> 10/3/2006 9:32:00 AM

The Center for Studying Health System Change (HSC) released the results of their recent look at the use of e-mail by doctors in the clinical environment. According to their data, 24% of doctors reported the use of e-mail to communicate clinical issues with patients. That represented a 5% increase over last year.

When searching for ways to ease the steady increase in healthcare costs, electronic communication has consistently been targeted as an area of opportunity. By allowing patients and doctors to interact over the web, practices can cut overhead and therefore reduce costs to insurers as well as the patients themselves. It also allows doctors to see more patients or spend a greater proportion of their time working on the most difficult cases.

President Bush has recognized the need for these types of changes and has stated that he would like all Americans to have electronic health records within 10 years. This plan would allow for easier and less costly sharing of information between specialists and GPs, but would also allow for more consultations, medication management and other contact to happen over the web. To this end, the Department of Health and Human Services created the American Health Information Community, a group that would move to advance the President's aims for health care innovation. The group targeted e-mail as a communication technology ready for breakthrough and rapid development, especially in the area of chronic condition care.

As the HSC's press release points out, this year's data isn't terribly encouraging:

Physician-patient e-mail is most common in larger practices. Physicians in staff/group-model health maintenance organizations (HMOs) and medical school faculty practices reported the highest rates of adoption (47% and 43%, respectively), followed by physicians in group practices of more than 50 physicians (29%). In contrast, only about 20 percent of physicians in practices with nine or fewer physicians reported adopting e-mail use, the study found.

However, growth in e-mail adoption essentially stalled in larger practices between 2000-01 and 2004-05. At the same time, smaller practices with nine or fewer physicians did have statistically significant growth in e-mail use.

As larger practices are most often the earliest adopters of technological advances, their stalled progress represented something of a setback in this area.

There are two major issues holding up progress at this point: first, many doctors aren't reimbursed or adequately reimbursed for the time they spend consulting over the web and second, to do web based medical consultation both parties must have web access and must be able to find an adequately secure channel through which to interact.

The first issue has already seen much movement over the last half decade. Insurers are typically the last to respond to changes in care, and as there were few companies and practices utilizing this new paradigm of care, they weren't quick to offer it as part of their coverage. New models, like ours here at Treatment Online, are bringing powerful web based tools to bear on healthcare. While our focus is on providing mental health services in a unique, customer friendly and cost efficient environment, other web tools should soon be available to focus on a whole range of care issues. As consumers show greater interest and enthusiasm for these practices, insurers will be more willing to cover them.

The issue of security, from the perspective of care, is a much more important one. Both doctors and patients must feel comfortable and safe that their interaction and information will be properly protected. Again, this issue can be resolved easily by forward thinking businesses. For many, the concern is that to interact through e-mail requires many patients to use services like Yahoo! Mail, HotMail or GMail, which don't use any encryption or even make use of e-mail scanning technology. If these interactions can take place through a web-based, secure, closed server, essentially cutting out any third party and allowing doctors to interact directly with patients, then security concerns should fade quickly. Here, Treatment Online provides an example as all our data goes through a 256-bit encryption on our servers before being transmitted, that way only those interacting are privy to the conversation.

There is tremendous potential for care over the web. The surfeit of high speed cable laid during the Internet boom of the 90's has given us all the tools to take greater control and responsibility for our care. Whether it's mental health, heart medication management or chronic pain treatment, e-mail and other communication technologies have a great deal to offer consumers in the world of healthcare.

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