(Digested from Medical Economics, 9/1/2006)
More than a half dozen insurers in several states have begun reimbursing doctors for online consultations with their patients. But not many doctors are taking advantage of this paid "online" work.
The Blues in Florida and Massachusetts have been paying $30 for online visits since the beginning of 2004, yet only a small fraction of the network physicians are doing them. According to a spokesman, doctors are reluctant to adopt health information technology, as well as being concerned about security and liability. Some physicians also fear that e-mail will cut into office visits and revenue.
Other doctors feel that online consults can be an effective way to improve chronic care and increase efficiency in a busy practice without reducing office visits. One doctor in Royal Oaks, Michigan, who has been e-mailing patients without reimbursement, does not want to expand it further, saying "Patients want to use e-mail for everything, instead of coming into the office. I don't think that is good medical care, especially for serious issues." Some experts cite the treatment of chronic conditions in arguing for online consults. For instance, a hypertensive patient could e-mail blood pressure readings so that a doctor could adjust medication as necessary without an office visit. Online visits can also increase efficiency by eliminating phone calls, which generally involve a multi-step process of handling by two or more people including the doctor.
Acknowledging concerns, the industry seems to be slowly adapting to this communication technology:
· Private sector companies have begun operations to serve as an information conduit between doctor and patient.
· The Blues are currently paying for such visits on a limited basis.
· Aetna has started paying for online consults through its fully-insured plans.
· Employers are showing interest in pushing the technology to the physicians because they see a benefit in offering additional access to their employees.
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