Demystifying Medicine One Month at a Time

Tag: e-patients

Internet House Calls

It’s not the first, but it’s generated a fairly big announcement:

A company called American Well has introduced virtual visits directly to consumers in Massachusetts. [They’ve already been doing it in 43 states and the District of Columbia.]

A hand with a stethoscope to give an examThe company has been partnering with insurance companies to provide internet-enabled visits to select populations. But now going direct to the public in the state with the highest number of doctors per capita has increased their visibility.

For the introductory price of twenty bucks (visits usually are forty-nine per), you can sign up and have a vetted medical professional (one that you select from a roster based on background, specialty, and availability) diagnose and even treat you for your problem.

Treatments include e-prescribing of antibiotics or other medications, in addition to advice. Potentially addictive controlled substance pain medications (Vicodin, Lortab, et al.) are not permitted.

Depending on your viewpoint, this is another step forward in technology enabling consumer-driven and consumer-friendly health care. Or it’s another insult to the primacy of the doctor (aka “provider”)-patient relationship and the “Medical Home” model.

Would you confer with a doc online, if you could see her and talk to her “live?”

Google Strikes Out

Yeah, that’s right. Google, the fabulously successful internet search giant, has been humbled in at least one market:

Online health records.

Like other tech companies before it, Google has learned the hard way that health care is a behemoth industry that is resistant to change its decades-old practices.

[By old practices I am referring here to health care financing and documentation; I’m not alluding to the pace of actual medical innovation, which seems to occur faster and faster with each passing headline.]

Google started the service, Google Health, in 2008. You can read the bulletin about its demise from the company here.

The idea is simple: Empower patients to upload their own health records online, stored in the “cloud,” so that they can be available anywhere anytime for use by the patient and whomever she chooses–doctor, nurse, specialist, consultant, physical therapist, yoga teacher, etc.

What’s not to like?

For one thing, privacy advocates worried about the security of such records. Libertarians worried about government and/or insurance companies using the records to screen out potentially unhealthy individuals to deny them coverage.

Perhaps the bigger barrier to adoption: inertia. Patients are very used to the idea of the doctor/practice/medical group/hospital keeping the records. It’s tradition, after all. One that’s apparently hard to shake.

As someone who works in this sector, I’ve increasingly come to feel that test results, lab values, even doctors’ notes that involve me should at the very least be shared with me. Freely and openly. Why should I have to jump through so many hoops to obtain them, like the dubious copying charges that health entities set up as a barrier to providing free documentation. Why not offer it all right up–electronically?

I keep an old fashioned paper record of my results. But I’ve never gone to the trouble of scanning the documents or uploading them to a cloud-based service like Google Health or Microsoft’s HealthVault.

Hmmm. I guess I can see why a pretty good idea like personalized online health records hasn’t panned out.

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