clinical innovations, e-medicine, Twenty Clinical Innovations to Build Patient-Doctor Trust: Sixth in a Series

On E-Visits, E-messages, and E-Consultations

E-mail arguably has become the most common means of personal communication. It is replacing personal letters, faxes, long distance calls, and is supplementing wireless cell calls. It is cheap and fast. It is giving new meaning to the word instantaneity. Everybody is doing it – businesses, advertisers, friends, kids, family members, and yes, even patients and doctors.

If you doubt the gathering email flood and its impact on patient-doctor relationships, I invite you to review this list of media articles on the subject:

You've Got Mail? Not from the Doctor. Just a Quarter of Physicians Use E-Mail to Interact with Patients, though Some Say It Can Save Time and Money.
Los Angeles Times, October 2, 2006

Digital Rx: Take Two Aspirins and E-Mail Me Morning
New York Times, March 3, 2005

The Doctor Is Online: Secure Messaging Boosts the Use of Web Consultations
Wall Street Journal, September 2, 2004

Blue Cross Doctors to Treat Patients Online
Florida Times-Union, September 1, 2004

Doctor@Office.com
Rocky Mountain News, August 23, 2004

Email Consultations in Health Care
British Journal of Medicine, August 21, 2004

Physician To Be Reimbursed For Plan Member Web Visits
MCIC, August 10, 2004

RelayHealth Makes The Right Connections For Virtual House Calls
HealthLeaders, July 2004

Doctors Advice May Be Just a Click Away
Orlando Sentinel, June 7, 2004

E-Visits Begin to Pay Off for Physicians
Information Week, May 31, 2004

Colella Brings Medical Networking Online
East Bay Business Times, May 28, 2004

The Doctor Will E-You Now
The Boston Globe, May 24, 2004

Online Messaging Defied Expectations
Health Data Management, May 21, 2004

Payer to Reimburse Online Consults
Health Data Management, May 11, 2004

Should You Pay Providers for E-Visits?
Managed Care Report, April 30, 2004

Take Two Aspirins, E-Mail Me Tomorrow
The New York Times, April 27, 2004

Improving Doctor-Patient Relationships via E-Mail
National Public Radio, April 22, 2004

Cyber-Doctors: Medical Groups See Web as a Prescription
San Francisco Business Times, April 16, 2004

Tenn. Blues to Reimburse Physicians for Phone Calls, Online Visits
Managed Care Outlook, April 15, 2004

Physician Organizations Communicating With HMO Patients Online
Health Resources Publishing, April 2004

Online Communication with Patients: Making it Work
Family Practice Management, April 2004

Communicating with Your Patients Online
Family Practice Management, March 2004

Doctors Meet Patients in Cyberspace Office
Business First of Buffalo, January 30, 2004

Virtual Access
Modern Healthcare, January 26, 2004

Doctor-Patient E-Mail Getting Hotter
Internet Healthcare Strategies, December 30, 2003

Reimbursement Code Could Increase Online Consultations
iHealthBeat, December 22, 2003

Online Consultations With Patients Grow
iHealthBeat, November 18, 2003

Web Allows Doctor Access
Democrat and Chronicle, September 20, 2003

Company Gives Docs Online Treatment
East Bay Business Times, August 5, 2003

IT Part of Payers' New Game Plans
Health Data Management, June 2003

Connecting With Technology
Unique Opportunities/The Physician's Resource, May/June 2003

Please Get The Doctor Online Now
Wall Street Journal, May 22, 2003

Online Chats Heal Wounds
USNews.com, May 19, 2003

Reimbursement for E-ail Visits Urged By Group
Family Practice News, May 15, 2003

Some Doctors Use Patient E-Mail In Their Practices, But Most Aren't Ready To Log On
Washington Post, April 1, 2003

HIPAA Demands Encrypted E-Mail
Family Practice News, April 1, 2003

Connecting With Consumers: Hospitals See A Payoff In Linking Patients and Doctors Online
H&HN's Most Wired Magazine, Spring 2003

Will Doctors Get Online?
Los Angeles Times, March 31, 2003

MD-Patient Online Communications: Finding Money in Clinical Encounters
Jupiter Research, 2002

Patients Skip the Waiting Room for Virtual Visits to the Doctor
Wall Street Journal, December 26, 2002

New ROI Data: The Virtual Doctor's Visit Cuts Costs
Forrester Research Brief, October 24, 2002

Online Doctor Consultations Show Promise in Pilot Study
Wall Street Journal, October 24, 2002

Just Open Your E-Mail and Say 'AH'
San Francisco Chronicle, November 11, 2001

Take Two Aspirin and Hit the Send Key
Newsweek, June 25, 2001

Digital Diagnosis
San Francisco Chronicle, May 9, 2001

Employers Urge Doctors to Make 'Visits' by E-Mail
Wall Street Journal, March 23, 2001

Impressive as this list is, it overlooks one salient fact. Doctors remain reluctant to use email to communicate with patients. According to the study by The Center for Studying Health System Change, a Washington, D.C. think tank, only 25 percent of doctors talk to patients by email, up from 20 percent four years ago.

The reasons given for this reluctance vary: greater malpractice exposure, fear of invasion of privacy, lack of payment, reluctance to treat unseen patients, inability to read body language and truthfulness of patients, or just another task for overworked doctors. The last thing many doctors want is another way for patients to get hold of them.

These doubts are likely to give way to reality as consumers demand more doctor access and less costly and more convenient ways to gain information. It will also become clear that being paid $25 to $35 for a virtual visit is a more economical than handling patient problems via telephone calls, for which doctors are paid nothing.

Moreover, businesses, health plans, and health organizations, such as academic medical centers, physician groups, and professional organizations are encouraging their constituencies to use email. Medem, Inc, backed by the AMA and many medical specialty associations, actively promotes electronic consultations, and RelayHealth, Inc, an organization selling communication products to the nation’s health plans, characterizes its services as “a secure private way to communicate with your doctors and to take care of non-urgent health matters – quickly and easily.”

Call patient-doctor e-mails what you will – e-visits, virtual visits, online messaging, and online consultations. The trend appears inevitable. Email visits may serve as bridge to more widespread use of electronic and personal health records. Doctors who introduce these visits into their practices may also find they gain their patients’ trust.