The number of products and services now available on-line is growing -- from groceries and books to movie tickets and medicines. Now, some Americans can get a medical check-up on-line.
For most Americans, a visit to the doctor is a lengthy process. They may have to take time off from work, get to the clinic or medical office, then wait until the doctor is available before they can even begin explaining why they're there. But, do patients really have to go through all that?
Probably not, says Chuck Kilo. "Undoubtedly, 50-70% of the cases in primary care, the answer is no, they did not really need to be there." Dr. Kilo heads a medical practice in Oregon that specializes in e-visits.
Dr. Kilo says on-line consultations aren't much different from office visits. Patients with chronic ailments like hypertension or diabetes usually came to see him just to have their charts reviewed. Now, he uses e-mail and electronic spreadsheets to monitor their blood pressure or insulin levels.
"We never want to be cavalier about the quality of care that we deliver," he stresses. "On the other hand, a lot of what we do in primary care can be done electronically or over the phone."
Advocates of e-visits -- like Jack Friedman, CEO of Providence Health Plan -- say the technology allows everyone to benefit. Patients can get medical advice quickly, securely and confidentially on-line, directly from their primary care physician. As he sees it, "Jumping in your car, taking an hour and a half off work, going to the doctor's office, waiting 35 to 40 minutes to see your primary care doctor for a 7 ½ minute or 8 minute visit isn't always the most productive way to get your primary care needs met."
Providence Health Plan is one of a growing number of insurance companies that covers e-visits, paying doctors the same amount they receive for traditional office visits. And without the small talk and patient hand holding, e-Visits save time, which means doctors can take on more patients.
Chuck Kilo points out on-line consultations can reach well beyond monitoring chronic ailments. He has many patients who use e-mail for routine medical questions, and some who use digital cameras to take pictures of a rash or bump and send them to his office for medical advice. "I saw somebody who came in this morning," he says, "she had basically an allergic reaction around a Band-Aid that had been applied. Had she snapped a picture of this, and shown it to me, I could have easily told her over e-mail 'Yeah, it is what we think it is, no reason for you to worry about battling through traffic and taking off work and coming in for me to tell you it's likely an allergic reaction'."
This type of care concerns Monique Levy. She's a senior analyst with Jupiter Research, a consulting firm that helps clients evaluate the impact of new technologies on their business. For doctors who treat patients over the Internet, she says, "it's hard to tell whether they're going to get all the information that they would be able to get from non-verbal cues or seeing the patient or monitoring and taking other types of vital signs. So, there's a risk that they're not going to get a whole picture of what's going on with the patient."
Ms. Levy says this leaves doctors and insurers vulnerable to lawsuits, if -- for example -- a treatment based on that 'partial picture' proves harmful. That risk, along with the high cost of setting up an on-line practice, has kept most doctors and insurers out of the e-visit business. But patient interest is growing, which means virtual house calls could soon be just a click away.
