Berkeley Study Examines Feasibility of Online Patient-Doctor Visits
The University of California-Berkeley has launched a new study to determine whether online consultations between patients and physicians well "lead to fewer actual office visits, or just more headaches for doctors," the San Francisco Chronicle reports. The study, backed by Blue Shield of California and Healinx Corp., which has produced a system for online doctor visits, will involve about 200 Blue Shield primary care physicians and 6,000 patients. In the study, about half of the patients either will send encrypted email messages or participate in a "structured" online visit, during which patients answer a series of questions about their conditions. The answers are then "transformed" into clinical notes and sent to the doctor through a secure Web site. The other half of the patients will serve as the control group, continuing to access doctors as usual. Participating doctors will receive $20 per Web visit, the Chronicle reports. The study, which began last month, is expected to take one year to complete. At the same time, several large, self-insured Silicon Valley companies are involved in a test program of Healinx that will involve nearly 2,000 employees and 100 doctors.
Proponents of online consultations say they are "expected to reduce the necessity of a back-and-forth conversation" by giving the physician "as much information up front as possible." Dr. Jeffrey Rideout, chief medical officer for Blue Shield of California, said the email program is designed to cover "nonurgent medical problems asked by a doctor's current list of patients" and is not meant for new patients. Although he speculated that Web visits might one day be expanded to monitor individuals with "chronic but stable conditions," he added that the online visits are not meant to "substitute complicated clinical care for visits over the Internet." Some patients and physicians have voiced concerns over the advent of online consultations, the Chronicle reports. Patients question whether Web visits will "start replacing" face-to-face visits, whether online consultations will offer the same quality of care and whether medical information sent via the Internet will be shared with other individuals or insurance companies. Physicians, however, fear that online visits might allow health insurers to "monito[r] ... their every move" and are afraid that they will be "inundated" with messages from "cyberchondriacs." Another "huge concern" for physicians is reimbursement, as some doctors question whether insurance companies will pay them for online consultations. Health plans, in turn, are wary that reimbursing large numbers of online visits will prove costly (Colliver, San Francisco Chronicle, 5/9).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.