Thursday, October 20, 2011

Unwelcome Advances? Why Doctors Will Survive When Patients Have Their E-mail Address

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The doctors will e-mail you now. At least, we hope they will.

For all the amazing potential held by personalized electronic health records (EHRs) the biggest obstacle to their wide spread use is getting physicians to consider corresponding with patients by e-mail as part of their jobs. In order to enable patients to communicate with their physicians and keep their EHR updated, most electronic medical records vendors provide a “patient portal.”

There are some good reasons why doctors aren’t crazy about the idea of providing thousands of patients with an electronic link to their office. Most physicians, who still practice under a fee-for-service reimbursement, do not get paid for answering patients e-mail, and their work days are already insanely busy.

Epic, the healthcare information technology company which now has more than 10 million people using its EHR called myChart, has compiled a list of reasons that doctors give to avoid using the tool to link with their patients. While many of these are eventually proven to be false concerns, they include: their in-boxes will be immediately flooded with patients’ questions; they will be giving away free care; and patients are already impressed with their care, so it isn’t necessary.

Despite all these concerns and the very real demands on their income, work days, and professional autonomy, there is a rather selfish reason why physicians should consider using a personalized EHR with their patients.

“It’s just so handy,” says Dr. Patrick Coleman, an internist with Piedmont Physicians Group. His practice uses NextMD, a patient portal that is part of the NextGen electronic medical record.

Piedmont Healthcare will transition to using Epic myChart beginning in August 2012.

Dr. Coleman admits to having a lot of the same concerns of other physicians until he was forced to start using NextMD more than two years ago and discovered “this isn’t so bad.”

He estimates that he responds to five to 10 e-mails a day from patients and it takes him less than 15 minutes. His staff handles the e-mails requesting prescription refills, scheduling appointments, and other items that don’t require a physician’s time. Corresponding with his patients by e-mail eliminates phone tag that occurs when patients call his office with questions.

“E-mail is so much easier on my staff,” says Dr. Coleman, who estimates that about half his patients use it.

He says e-mail has changed the way he practices medicine. He uses voice recognition software to e-mail lab results to his patients, complete with his explanation of the findings, within 36 hours.

Dr. Coleman expects that we are only beginning to see changes that will involve the patient. He envisions a day when the practice can actually start the physician visit at home. For example, a patient with a sore throat may complete a questionnaire that will then be integrated in the patient record and make the visit that much more efficient.

With a shortage of 45,000 primary care physicians projected by 2020, we are going to need more efficient ways of providing care, according to Andy Miller, editor of Georgia Health News.

In the meantime, for the many physicians being pressured to offer e-mail correspondence to their patients, remember the brave discovery of those who have gone before you: “this isn’t so bad.”

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One Comment

  1. Posted October 27, 2011 at 2:28 pm | Permalink

    “”On the Internet No On Knows You’re a Dog (or a Doc)”"
    I’m not all the way up on the latest reimbursement rules, but in most industries CRM and electronic messaging have introduced huge productivity gains on both supply and demand sides: data mining on one end and VR on the other divert most calls to the right place more quickly more often. Looking forward to self-learning machines (e.g., Dr. Watson) why wouldn’t PHP’s begin to see e-mail as no more nor less than their side of an amplified value chain: i.e., systems wherein less vital messages are diverted to less trained staff (and/or AI) while they get more opportunities to treat the more serious afflictions?

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“Hi, I’m Ed Lovern, the executive vice president and chief administrative officer for Piedmont Healthcare in Atlanta. I created this blog to share my thoughts on the healthcare revolution and how we can all be part of the solution. Feel free to comment or email me your thoughts – I would love to have your contributions and feedback.”
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