Tech-Savvy Docs Resist Virtual Visits

Patients want to communicate with their doctors online and they are willing to pay for it. But until reimbursement issues are perfected, physicians won't give out their e-mail addresses.

Patience is running out for those who want to communicate via the Internet with their physicians, according to an online nationwide survey of 2,014 adults by Harris Interactive. Almost all (90 percent) of those surveyed expressed a desire to be able to contact their doctor online, and 37 percent would be willing to pay out-of-pocket for the opportunity.

More than two-thirds of the respondents would like to be able to do each of the following: ask questions where no visit is necessary (77 percent), fix appointments (71 percent), refill prescriptions (71 percent), and receive the results of medical tests (70 percent).

Affluence factors into a patient’s willingness to pay for the ability to communicate with their physicians. In the less than $15k annual income range, 37 percent would be willing to pay; 39 percent would not; and 24 percent were unsure. At the high end of the spectrum, the $75k+ range, 45 percent expressed willingness to pay for online communication with their doctors; 39 percent would not; and 16 percent weren’t sure.

When asked if they would be willing to pay a fixed monthly amount, 42 percent said they would pay between $1 and $5; 33 percent were agreeable to the $6 to $10 range; and one-quarter of the respondents would pay more than $10. When presented with the pay-per-message option, a rate of $1 to more than $5 was agreeable to those that were willing to pay at all for the ability to communicate with physicians.

The majority (55 percent) of those surveyed say that if one health plan enabled them to communicate with their doctors online and another did not, this would influence their choice of plans. A significant minority (12 percent) says they would be influenced “a great deal.” More than half (56 percent) also say that if one doctor allowed them to communicate online and another did not, this would influence their choice of physicians. One in seven (14 percent) say this would influence them “a great deal.”

The obstacles to communication lie in physician concerns about reimbursement, privacy of patient information, and potential malpractice liability. Several organizations are working on ways to address the malpractice liability and medical records’ privacy issues in online communications between doctors and patients. If they do so successfully, the main barriers will be reimbursement and financial incentives for doctors.

Reimbursement seems to be a major factor in online communication between doctors and patients. A Deloitte Research and Fulcrum Analytics telephone survey of 1,200 practicing U.S. physicians revealed that they believe a 15-minute email consultation is worth $57.

The survey indicates that twenty-three percent of queried physicians report that they interact with their patients by email, up only four percent from last year. Of the doctors not currently emailing their patients, 79 percent indicated that their preference for “face-to-face” communication was the primary reason for not interacting with patients online. Of those physicians, 54 percent say insurance reimbursement is the leading driver for them to email their patients in the future. Only 9 percent of doctors responding to the survey did not expect reimbursement for email interactions with their patients. Other future drivers of adoption include the ability to: reallocate staff (43 percent); save time (42 percent); see more patients in a week (37 percent); and cut expenses (37 percent).

Other findings include:

  • Even though doctors indicated some reluctance to engage in widespread email communications with patients, 55 percent do recommend certain credible Web sites to their patients.
  • Virtually all doctors who responded to the survey are not prescribing electronically, but 40 percent express future interest in electronic prescribing, given the right system is designed, developed and managed properly.
  • According to the survey, 32 percent of online doctors visit pharmaceutical corporate Web sites with 61 percent visiting to learn about new drugs and 51 percent learning how to prescribe those drugs.

Physician reluctance to communicate with patients online should not suggest that they are not technologically inclined. Over half of all physicians who responded to the survey indicate that they hope to view lab results via their PDAs in the future, but the applications and infrastructure at the practice or hospital level needed to support this functionality are under development. Therefore, of the 30 percent of all physicians who report that they currently own a PDA, 84 percent maintain their personal schedules and 67 percent manage their professional scheduling through the device. An additional 57 percent of these same doctors are using the device to access drug databases.

“Physicians will not adopt technology for technology’s sake or just because it’s the next new hot idea. Our survey clearly indicates that physicians evaluate emerging information technologies very carefully, looking for the creation of real and sustainable business and clinical value,” said Jason Girzadas, principal, Deloitte Consulting Health Care Practice.

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