The doctor-patient relationship is moving online. With 68% of American adults now using the Internet to search for healthcare information, it's no surprise that many also want digital access to their doctor. Whether they have that option will depend heavily on doctors' ability to get paid for the service. As of last year, less than 5% of doctors communicating online with their patients were being paid to do so. That's slowly starting to change as big insurance companies, such as Cigna, Aetna, Anthem, and Humana, have begun to reimburse doctors for online clinical consultations.
Privacy Concern is the Primary Obstacle
Patients want to communicate with their doctor via e-mail, but there are security risks. Sending health information to a doctor through a private Gmail or Yahoo account isn't a safe. You have to find a way to ensure you're communicating with the appropriate person on the other end. You need a secure site that requires a log-in with a user name and password. Insurance companies require that online consultations or e-visits as they are called take place through a secure Web portal with high levels of encryption that comply with Health Insurance Portability and Accountability Act (HIPAA) privacy rules.
New Payment Mechanisms are on the Horizon
Currently, 12 states, including California, have laws on the books requiring health plans to pay for online medical services. E-visits generally fall under that umbrella. At the national level, a Center for Medicare and Medicaid Innovation has been formed to help facilitate technology that would let doctors meet with their patients through video chats, telephone checkups and in-home monitoring devices. And most recently, the Department of Health and Human Services issued $220 million in grants to 15 communities around the country for creating three-year pilot programs to test the adoption of healthcare technology, including e-visits.
E-Visit Technology Available Now.
Various types of technology are used for e-visits, including simple e-mail but also live online visits using Web-based video or phone through companies such as RelayHealth, American Well, MDLiveCare and SwiftMD. Aetna has a proprietary online consult program called webVisit, but only about 1% of their providers use it.
Follow the Money
Although insurers have started to recognize the value of e-visits, most still don't pay for them. Neither does Medicare. That makes e-mail communication just one more daily task that primary-care doctors are saddled with and not paid for. Growing consumer pressure will no doubt force the healthcare industry online, but, ultimately, it's the money that will lead doctors to their computer screens. There is no incentive for doctors to change at the current time.