Online Communication between Doctors and Patients: Are there still kinks in the link?

by Matt Bichler

For the past ten to fifteen years the idea of doctors and patients communicating with one another online has become increasingly feasible. Growing right alongside this feasibility was patient demand for the service. As with all new technologies, this one came with its own set of problems. There was skepticism from doctors and patients alike.

The primary concern of the patients was keeping their medical information private. This seems a very reasonable concern considering that most online communication is through email. It is common knowledge that any personal information you wish to stay private should not go in an e-mail.

The primary concern of doctors was getting reimbursed for giving their expertise online. The following quote sums up doctors concern over the issue: "This may sound mercenary," Dr. Johnson says, "but all I have to sell is my time, and if I give it away, I'm out of luck"(Wiebe 2).

Thousands of companies today are getting paid for online services. Computer companies like Dell charge for online support when you need help fixing your computer. Cabela's sells merchandise online. So why don't doctors just get on board?

The answer is red tape. Hundreds of insurance companies and the government (Medicare) pay most of the medical bills Americans accrue. If doctors are unsure whether insurance and Medicare will cover online consultations, how can they create a complete payment method for online consultation?

As I mentioned above, the idea of online communication between doctors and patients is ten to fifteen years old. Most of the articles that posed these privacy and reimbersment concerns were written five to seven years ago. So are these concerns still valid today? Unbelievable as it sounds the answer is both surprising and cliché.

A big step was taken toward a resolution for doctor reimbursement issues. Several large insurance companies have begun paying doctors for online communication:

"...Blue Shield of California and First Health began paying $20 to $25 for "e-visits" for certain chronic illnesses, and now Aetna, UnitedHealth, ConnectiCare and other Blue Cross Blue Shield plans have started pilot programs..." (Sherger 1)

Dr. Sherger, a professor of family medicine at University of California adds that if the patient's insurance companies do not cover online consultation, physicians could simply charge an up-front monthly fee for the service. Just like online shopping or internet poker, patients could pay with a credit card or an online account. Whether or not consumers will frequently use the service if insurance does not cover the cost remains to be seen.

Solving problems with patients' privacy was a matter of going more high tech than simple e-mail communication. Aetna, one of the insurance companies mentioned above, used a company called RelayHealth to deal with patient's privacy concerns:

"RelayHealth is more secure than e-mail. Unlike e-mail, which relies on multiple servers across the Internet, RelayHealth uses a single, centrally managed database for doctor-patient communications" (Aetna News 1).

In short, using one central database makes it much harder for anyone outside to gain access to your information.

Surprisingly, both reimbursement and privacy concerns were solved by insurance companies. It is no surprise why, though. The general consensus of the articles I researched shows consumer demand for online communication with their doctors is extremely high. The ability to offer this service became a way for insurance companies to set themselves apart from the competition. The cliché is that this is just another case of demand equals progress.

Works Cited:

"Aetna to Offer Secure, Reimbersed Online Communication Between Members and Doctors." Aetna. 4 April 2006.

Sherger, Joseph E. "Online Communication with Patients: Making it Work." American Academy of Family Physicians News and Publications. April 2004.

Wiebe, Christine. "More Doctors Hit 'Reply' to Patients' Email Queries." 2 January 2000.

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