US doctors offer online consultations

Apr 21, 2008, 3:07 GMT

Washington (dpa) - When Dr Michelle Eads makes a house call, she no longer has to spend time in her car sitting in traffic.

For that matter, she also no longer has to pull the patient's chart and look up their phone number, hoping the patient will be available to take her call.

Eads, who practices medicine in Woodland Park, Colorado, checks on several of her patients by logging onto the internet and answering their questions online.

Eads says her practice is always seeking new ways to achieve better results for patients and to improve. She is convinced using the internet to respond to patients is a good idea.

Virtual Online Visits (VOVs) 'are more efficient and convenient since they don't require a telephone call, being placed on hold, missing work, arranging for a sitter, paying for parking, etc,' Eads said in an interview posted on the website www.transformed.com, a programme focused on redesigning US medical practices sponsored by the American Academy of Family Physicians.

For years, patients have been able to request a referral or an appointment or have a prescription refilled using e-mail or via secure medical internet portals. But there has been some resistance to implementing such practices because of concerns over payment and privacy.

RelayHealth, a website that describes itself as a secure, private way of communicating with a doctor, hopes to overcome those anxieties.

Last year, two major US health insurers began aggressively marketing RelayHealth to about 1 million doctors across the US and many are paying heed, according to a report on US public radio.

A study by the New York market research firm Manhattan Research confirms the increase in doctors' use of the internet to serve patients. Thirty-one per cent of family doctors are offering online consultation, up from 19 per cent in 2003, Manhattan Research found.

About one-quarter of the family doctors who do not yet offer the service plan to do so within the next year, according to the research firm.

Eads describes her patients as 'thrilled' over online consultations. She uses the internet frequently for people complaining about upper respiratory infections, sinusitis and chronic disease management, including follow-ups for controlling hypertension and diabetes.

'I still see patients every six months if they are well controlled, but the three-month in-between appointments are easily handled in this format,' she said.

Eads also issues prescriptions online, but only if she knows the patient well and only if the prescription is a refill.

Patients like the service because they can have a VOV any time, read it at their own pace and from any computer with internet access.

They can easily find a secure link for VOVs from her webpage where the patient's medical history is compiled. They can refer to a list of the most common ailments - from acne to asthma and from depression to dizziness - and report their problems by clicking.

If desired, patients also can send an e-mail attachment that includes pictures, a blood pressure record or even send an audio file containing the sound of their cough.

VOVs are practical for doctors because they can determine when they want to handle them and also whether the need to see the patient in person.

'There is a substantial savings there,' Joe Mondy, spokesman for Cigna, a major US health insurer, said on public radio. 'In addition to that cost savings there is also, of course, a time savings.'

The cost of a VOV is 25 dollars (16 euros), while a traditional visit to a doctor's office costs 65 to 85 (41 to 54 euros).

The University of Maryland also offers basic medical advice on a website. Patients can send queries per e-mail to more than 60 experts and expect an answer within 24 hours. The site receives about 10,000 questions annually, said Edward Bennett, director for web strategy at the University of Maryland Medical System.

As opposed to VOVs, the university's service simply makes information available, said Bennett. The university's websites doesn't 'treat' patients over the internet, he said, warning people not to have exaggerated hopes about diagnoses. Patients must be examined personally in order to arrive at a correct diagnosis, he said.

But Bennett said he believes VOVs have a place in medicine, particularly among patients who have had the same doctor for a long time and the doctor knows their medical history. Then internet medical consultations become a good supplement to regular care.

Eads said she offers the service only to patients she has had for a long time. These are people whose conditions she knows and therefore can react to their problems appropriately. And, as before, if they feel uneasy about a situation, they should go personally to the doctor's office for an examination.