A Whiff of Innovation

Rick Johnson, Senior Editor , July 12, 2007

Perhaps I should e-mail my family physician, because the left side of my body aches and I'm experiencing limited range of motion in my shoulder. My discomfort is the result of a wiffleball game last night that began friendly enough but quickly turned heated.

I was patrolling the outfield when Matt Cann--the publisher of HealthLeaders Media--smacked one hard to left field. I was the only outfielder on a three-man squad, so I had some ground to cover. Running full speed, I was just able to tap the ball with my fingertips into the air before I stretched out horizontally to make a diving catch.

I managed to hang on to the ball when my body crashed with a thud on the freshly mowed lawn. In that moment, I felt a mix of pride in this circus-style catch and stupidity in nearly dislocating my shoulder over an unofficial wiffleball game. (My team won 13-12, but who's counting?)

In typical male bravado, I "walked it off" and finished the game, but I knew immediately that I would be sore the next day. At 35-years-old my body just doesn't bounce back the way it used to.

I could imagine my doctor's e-mail reply to my report of stiffness and pain: "Seriously, Rick, no one should ever dive head first in a wiffleball game."

I'll just take a few Advils today and see how it goes. But I could e-mail my physician if I wanted to. Through RelayHealth, my doctor provides his patients with electronic health records and secure e-mail. I haven't had much need to use it, but my wife, Cindy, has. Our doctor has sent her referrals and test results electronically, and Cindy has replied to the staff with follow-up questions.

I find this use of technology to be very handy for those of us too busy to wait on the phone or schedule an appointment for non-urgent questions. And I'm not the only patient interested in online health management. In fact, a new Kaiser Permanente study found that patients who use their electronic health records were seven to 10 percent less likely to schedule an office visit. Overall the authors concluded that "e-mail is more convenient and efficient for both the physician and patient for non-urgent concerns."

My wife heard similar opinions when she wrote about this topic last year for her newsletter, Medicine on the Net. (Yup, we both write about healthcare, so it makes for fun dinner conversation.)

"It's unrealistic and extremely frustrating for both the patient and provider to try to use the phone as a means to communicate, because no one is ever available," Kathy Gregory, MD, an obstetrician and gynecologist in San Francisco, told Cindy. "I find that I can answer seven questions [via e-mail] in the time it would take me to get a hold of on person on the phone."

Even though there are some early adopters out there, most physicians don't use these Web-based tools to communicate electronically with patients. Only about one in four physicians reported using e-mail to communicate clinical issues with patients in 2004-05, according to a study conducted last year by the Center for Studying Health System Change.

During my last exam--a routine check-up, not wiffleball related--I found it reassuring when my doctor cracked open his laptop and typed new information into my record via a secure wireless network. It allows me to go online and review notes and alert the staff of anything that isn't accurate.

Maybe as insurers begin to reimburse physicians for services provided online, more will add the technology to their practices. E-mail has become so ubiquitous that it only makes sense for doctor-patient communication--even if I don't use it report my latest pseudo-sports-related injury.

Rick Johnson is a senior editor with HealthLeaders Media. He can be reached at rjohnson@healthleadersmedia.com.

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