July 14, 2014

We Still Can't Email Our Doctors

Technology has it good points, but many in the medical profession refuse to make use of the technology. Having been burnt by the electronic medical records and how it has damaged doctor-patient relations, I can have some sympathy, but not much. What scares me is that most doctors refuse to use emails, except for personal family correspondence.

Why is the question I keep asking? Not a doctor will answer me. The Office if the National Coordinator for Health Information Technology says that within the next decade, “all individuals, their families, and care providers should be able to send, receive, find, and use health information in a manner that is appropriate, secure, timely, and reliable.” Secure will depend on what the government wants and if they will rein in the NSA.

Forget about the lame excuses offered by government and the medical professions, email communication will soon happen as more patients start demanding this and more medical professionals start realizing the advantages. The medical professions may need a few solid and well-placed kicks where they sit to convince them, but even many of the doctors using contract medicine are already reaping the benefits of secure email and reducing the office visits.

Money is the great roadblock and is the cause of the providers' reluctance to adopt email in their practices. Nearly one million doctors rely on Medicare reimbursement and Medicare presently will not pay for emails or e visits. The American Medical Association rescinded its 1994 prohibition on rendering clinical telemedicine services and should be adequately compensated for email consultation. Privacy and security concerns are another reason providers have snubbed email. And who can blame them? Anxiety over the possibility of a HIPAA breach has escalated to a level of hysteria.

About half of Americans’ and Canadians’ 600 million annual primary care visits could be transacted online instead of face to face. Fees for e-visits range from $35 to $75 out of pocket, but can be as little as $15 with an insurance copay. Congress is considering legislation intended to shore up Medicare’s telehealth payment infrastructure. In addition, Medicaid programs cover electronic messaging in a wider variety of platforms and circumstances than Medicare does, and private payers must match that coverage in 19 states and in the District of Columbia.

There is much that needs to be improved and roadblocks removed, but don't expect this to happen anytime soon. More people are needed to write their Congressional people and encourage them to wrap Medicare into the positive column.

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