Wall Street Journal Looks at Obstacles to E-Mail Consultations
Although physicians increasingly are incorporating the Internet into their clinical and administrative processes, most still do not use e-mail to communicate with patients, according to a feature in today's Wall Street Journal. According to the Journal, experts say that liability concerns and lack of compensation are the "two basic problems" behind physicians' reluctance, and efforts by malpractice insurers, medical societies, health plans and private companies have not yet made much progress against either concern. A recent Harris Interactive poll finds that only 13% of physicians communicate with patients by e-mail, while a new Deloitte Consulting/Fulcrum Analytics report puts the number at 23%. Medem, a for-profit venture that provides health care professionals with Web sites that include secure messaging capabilities, recently found that fewer than 10% of its physician users use e-mail to communicate with patients on a daily or weekly basis. Approximately 60% reported that they "never" exchange e-mail with patients.
Medem is one of about a dozen players in the health care industry attempting to encourage online consultations. Medem is testing an online consultation service that is scheduled for broad release this year. It will allow physicians to consult with existing patients online and bill their credit cards for the service. Blue Shield of California also offers physicians a Web-based clinical messaging system and pays a $20 fee for e-mail consultations that require medical evaluations. Nonetheless, most health plans still do not consider e-mail consultations a reimbursable service. Moreover, physicians in the Deloitte survey said they think a 15-minute e-mail consultation should be worth $57, not $20. And, although Medem has worked with malpractice insurers to develop guidelines for physician use of e-mail, more than half of the Medem physicians surveyed said they are concerned about security and legal liability. Still, some providers are pushing ahead. For example, Boston's CareGroup hospital system began offering patients the opportunity to exchange e-mail with physicians more than 10 years ago through its PatientSite service. The secure Web site now includes 100 physicians and serves 5,500 patients (Landro, Wall Street Journal, 2/11).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.