Navigation Links
The doctor will email you now
Date:8/5/2013

NEW YORK (August 5, 2013) -- Patients like it and so do health organizations, but electronic communications in clinical care will likely not be widely adopted by primary care physicians unless patient workloads are reduced or they are paid for the time they spend phoning and emailing patients, both during and after office hours.

Those are some key conclusions of an in-depth examination by investigators at Weill Cornell Medical College of six diverse medical practices that routinely use electronic communication for clinical purposes. The detailed report, the most comprehensive of its kind, appears in the August issue of the journal Health Affairs.

"Leaders of medical groups that use electronic communication find it to be efficient and effective -- they say it improves patient satisfaction and saves time for patients. But many physicians say that while it may help patients, it is a challenge for them," says the study's lead author, Dr. Tara F. Bishop, an assistant professor in the Department of Public Health and Medicine at Weill Cornell Medical College.

"The lack of compensation is one issue, and another is that unless the practice takes steps to reduce a physician's daily workload of patients, communicating with patients is extra work that makes some doctors feel that their day can never end," she says.

Still, pressure from patients and from practice management may ultimately force physicians to communicate with their patients via electronic health records or secure email, Dr. Bishop adds. "I think there are ways to make a transition to electronic communications in health care work. Our study offers some good examples, but I still think we have a long way to go before physicians routinely email their patients."

Five-50 patient emails per doc per day

The push for electronic communications has been widely endorsed as a means to improve quality of care by, for example, emailing test results to patients, or managing clinical conditions without requiring a time-consuming and costly office visit. Still, few physicians use it. By 2008, the latest year for which figures are available, less than 7 percent of physicians regularly communicated with their patients electronically.

Dr. Bishop sought not to conduct a national survey of use of electronic communication in doctors' offices, but to investigate how different practices use it, how successful they are, and what barriers they face.

She and her team interviewed leaders of 21 medical groups, and also interviewed the health care staff, including physicians, in six groups that use electronic communications extensively, but varied in their approach. Five of the six medical groups were large-- four had more than 500 physicians and one had 115 physicians. The sixth had 15 physicians within a large academic medical center. None were affiliated with Weill Cornell.

The leaders said they started electronic communication programs to improve access to care and communication with their patients. All six practices used the program to communicate test results, to allow patients to request medication refills, appointments and to ask questions of their doctors. Three practices used nurses, medical assistants or case managers to triage messages from patients; in the other three practices, patients could email nurses for refills or the front desk for appointments, but they could also email their physician directly. The volume of emails that reached physicians in the six programs varied from five to 50 daily.

Only one clinic charged patients for "e-visits"-- email that involved clinical decision-making. This group negotiated reimbursement for e-visits with private insurers and patients paid a copayment. Another clinic imposed a $60 annual fee for unlimited electronic communication, but later dropped the charge because competitors provided the service for free.

Two medical groups added "desktop Medicine time" to their physician's schedules, while another allowed providers to decide how many patients they would see each day, thus providing time for electronic communication.

"The work never ends."

The advantages of electronic communication in these groups were obvious and they outweighed the disadvantages, says Dr. Bishop. "We were told that patients love this model. Leaders and frontline providers also said the system was efficient, safe, and helped them provide high-quality care. Physicians also said it was an efficient form of communication for them."

The researchers found the primary disadvantage to using electronic communication is that it creates more work for providers. "One leader said that the work never ends. It takes a psychological toll on some people -- the feeling of never being done," Dr. Bishop says. "Another said that in one day, he sometimes sees 10 patients face-to-face but communicates with another 50, commenting that he works all the time."

The researchers found that physician resistance to change and lack of payment are barriers to use of electronic communications. "One leader told us that insurance companies said that if physicians are doing it for free, why should we pay for it?" Dr. Bishops says.

While electronic communications does seem to reduce office visits for individual patients, many physicians do not have a decreased overall workload -- their clinics send them additional patients to see, she adds.

She says these issues can be addressed by team-based care that manages electronic communications and workload, or by compensating physicians for electronic communication in ways other than traditional fee-for-service, which does not yet include payment for time spent on emails, Dr. Bishops says.

"Despite the fact that we found experiences with electronic communications were, on the whole, very positive in the groups we studied that have embraced this technology, we believe the big stumbling block to its widespread use around the country will be compensation," Dr. Bishop concludes. "Until different payment models emerge, electronic communication is unlikely to be widely adopted by physician practices."


'/>"/>

Contact: Sarah Smith
sas2072@med.cornell.edu
646-317-7401
Weill Cornell Medical College
Source:Eurekalert

Related medicine news :

1. Study finds doctors have exaggerated fears when starting patients on insulin
2. Doctors Detail High Costs of Fighting Malpractice Claims
3. Callahan honored for improving older adults health in their doctors offices
4. A fish a day keeps the doctor away?
5. Doctors Urge Routine Skin Screenings
6. AMA committee recommendations on doctor fees set by Medicare are followed 9 times out of 10
7. Doctors Restore Some Hand Function to Quadriplegic Patient
8. Men Can Still Ask for PSA Test, and Some Should, Doctors Say
9. Female Doctors Earn Less Than Male Counterparts: Study
10. Male doctors make $12K more per year than female doctors
11. Is it constitutional for states to regulate pharmaceutical gifts and meals to doctors?
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/26/2016)... ... , ... Quality metrics are proliferating in cancer care, and are derived from ... of the beholder, according to experts who offered insights and commentary in the current ... For the full issue, click here . , For the American Society of ...
(Date:6/26/2016)... ... ... legally blind and certified personal trainer is helping to develop a weight loss fitness plan ... fix the two major problems leading the fitness industry today:, , ... They don’t eliminate all the reasons people quit their exercise program ...
(Date:6/25/2016)... , ... June 25, 2016 , ... The temporary closing of Bruton Memorial Library on ... Observer , brings up a new, often overlooked aspect of head lice: the parasite’s ability ... fumigation is not a common occurrence, but a necessary one in the event that lice ...
(Date:6/25/2016)... (PRWEB) , ... June 25, 2016 , ... ... athletes and non-athletes recover from injury. Recently, he has implemented orthobiologic procedures as ... City area —Johnson is one of the first doctors to perform the treatment. ...
(Date:6/24/2016)... Marne, Michigan (PRWEB) , ... June 24, 2016 , ... ... To deal with these feelings, many turn to unhealthy avenues, such as drug or ... Center of Marne, Michigan, has released tools for healthy coping following a traumatic event. ...
Breaking Medicine News(10 mins):
(Date:6/24/2016)... , June 24, 2016  Global Blood ... biopharmaceutical company developing novel therapeutics for the treatment ... today announced the closing of its previously announced ... stock, at the public offering price of $18.75 ... offering were offered by GBT. GBT estimates net ...
(Date:6/24/2016)... -- Dublin ... the " Global Markets for Spectroscopy Equipment" ... This report focuses on the global market ... its applications in various applications. The report deals with ... main industries: pharmaceutical and biotechnology, food and beverage, and ...
(Date:6/24/2016)... , June 24, 2016 The Academy ... of recommendations that would allow biopharmaceutical companies ... with entities that make formulary and coverage decisions, a ... "value" of new medicines. The recommendations address ... not appear on the drug label, a prohibition that ...
Breaking Medicine Technology: