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Tuesday, April 01, 2003MedStar Health, which owns hospitals in the District and Maryland, is offering a secure e-mail option to doctors affiliated with the hospitals. The pilot project is free for the first year. After that, doctors may have to pay an annual fee or $2.50 per e-mail they send. Other hospital corporations are considering similar moves. $2.50 per email is pretty steep. Expect that cost to be passed on to the patient, and if people balk at paying it or if insurance companies won't reimburse it (which they won't,despite the few who are doing it in the article) then forget about email. And then there’s the concern that patients will email with an emergency and go unanswered for a while: "How can a patient be sure that I'm sitting by my computer when they are trying to reach me?" worries David Eisenman, an ear, nose and throat specialist with a group practice in Washington. That's especially a worry for pediatricians, who will often take prescription refill requests or appointments by e-mail but are often reluctant to communicate by e-mail [about other matters] lest a message about an emergency go unnoticed. "If a parent phones in, we can assess the situation right away," says Jeffrey Bernstein, head of a four-doctor practice in Silver Spring, "but it's not possible to continuously monitor a computer screen to make sure we're not missing an emergency." This may seem self-evident. Who in their right mind would email a doctor about an emergency and expect an answer right away? You’d be surprised. A colleague of mine had an asthma patient arrest waiting for her to call back on a weekend. She couldn’t reach her because the patient had given the answering service the wrong number. I’ve had other patients leave messages on the office answering machine that were clearly emergencies instead of waiting for the answering service to pick up. It’s much too likely to happen. And diagnosing and treating via email? Not wise. Fewer and fewer people seem to believe this these days (including doctors) but you really do need to examine a patient to make an accurate diagnosis. Email is even worse than phone calls for this because it doesn’t have any real interaction (voice clues, the opportunity to get quick answers to a question about a symptom). In fact, most doctors who use email take their time in answering it: But even if you tell your doctor you'd rather he e-mailed than phoned you, you may still find yourself waiting longer than you'd like for a reply. In a survey last year by Harris Interactive, doctors said they respond to patients e-mail questions within 18 hours of receipt. But patients said they received replies about 30 hours after their messages were sent. I’d say that puts email somewhere between the fax and the phone for response time. posted by Sydney on 4/01/2003 08:10:00 AM 0 comments 0 Comments: |
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