Posted by: ateedub | July 10, 2008

Healthcare Delivery in the Internet Age

The Internet is supposed to change the entire world, but I’m still waiting for it to change my healthcare.

Well, that is a bit of an overstatement. My doctor and all of the physicians in her practice use electronic medical records (EMRs) to keep patient records. In fact, since the day I first saw her, I’ve never had a paper record at her office. She comes in with her mini-laptop, plugs it into the cord that’s in every patient room, and quickly runs through my most recent list of prescriptions to make sure she’s got everything up to date. Yeah, she rocks my world.

But I read a couple of interesting articles recently about the Internet revolutionizing healthcare delivery. The first described what I would imagine the future of primary care will be – going to the see the doctor online. It failed. Miserably. The WSJ Health Blog reported:

At Brewer’s office the technical end works as promised, but patients don’t really seem interested. They don’t want to pay the (usually unreimbursed) $30 for the online visit with Brewer, and they’s rather just send a regular email, even though it’s vulnerable to snooping.

Before I get into the mechanics of this, let me first say that I’m disappointed that the WSJ would cop out this much – they’re reporting on Dr. Brewer, who happens to be a columnist for the Journal. They do disclose this in the posting, but it just makes me less interested in the story. I mean, if he’s a columnist for them, let him write the story himself, don’t “report” on it.

Anyways, Brewer and his colleagues have an “expensive” website ($1800 a year) that they can no longer afford to maintain because patients aren’t using their $30 a pop online visits. I’ve got a lot of issues with claiming that “patients don’t really seem interested.” There are a lot more questions that need to be answered about this story:

  • What kind of private practice can’t afford spending $1800 a year on their website? And in what world does that count as an “expensive” professional website? Granted, the group is also paying per transaction, but that shouldn’t be a problem for them right now if they don’t have many transactions!
  • Is Forrest, IL the right place to test this kind of initiative? Are people very spread out so getting to the doctor’s office isn’t easy? Or is it a very urban environment like DC where people don’t have time to get to the doctor?
  • What kind of promotion did the practice do for this site? Were their patients aware that it existed?
  • Is the patient population in for Forrest Family Practice a tech savvy group? Are they comfortable using the internet to communicated with their doctor?

Brewer created a forum on the WSJ site to ask about people’s opinion about email with their doctors. Generally, the response was pretty positive – the big exception being doctors worried about liability.

So is it too crazy to think about virtual doctor’s visits? Apparently not in the UK.

Cancer Research UK, a cancer charity somewhat similar to the American Cancer Society (ACS) in the US, has launched Cancer Chat, “a forum with a difference.” It’s an online forum like many others dedicated to talking about your experience with cancer. The difference is that this forum is moderated. They’re calling it “an information safety net.” I call it moderated because they’ve got a team of staff members making sure patients are not subjected to false information or quack cures. This isn’t a bad thing, let’s just call it what it is.

The really interesting thing is that the website doesn’t trumpet this fact. Patients and caregivers use the internet to share experiences with one another. They also search for information about diagnoses, treatments, and more. For both of these, users seek assurances that information is accurate. So I would think that the moderation would be a big selling point. Strange that they don’t take more advantage of it.

Anyways, it will be interesting to see how Cancer Chat works in the long term. Looking at the discussions thus far, it doesn’t look like it’s been so successful yet. After a week, the symptoms, testing and diagnosis section has 4 topics with a grand total of 23 posts.

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Responses

  1. I don’t understand the knock on the Health Blog noting Dr. Brewer’s column. We do a mix of posts–some are originally reporting and others summarize noteworthy material from a range of publications, including WSJ.

  2. Hi Scott,
    Thanks for your comment. I was just disappointed to find out that this interesting story wasn’t a random insight. By blogging about your own columnists, you’re promoting your own site – and there’s nothing wrong with that. But this was an interesting story to me, and I would have liked to hear more about it from Dr. Brewer himself (not just the forum). Since he one of your columnists, I would have expected to see that.

    Alternatively, I would have liked to see links to other stories on this topic. The WSJ is one of the top newspapers in the world, and I honestly expect to see a little more reporting, even if it’s just your blog.

    [cross-posted to WSJ Health Blog: http://blogs.wsj.com/health/2008/07/09/a-primary-care-doc-builds-an-electronic-office-and-nobody-comes/#comments ]


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