Monday, January 3, 2011

Doctors begin to embrace the Web

This news story appearing on the Kaiser Health News site makes the case that it is convenient for patients to be able to view their physicians' schedules and make appointments online.

Physicians can make this service available to patients through a vender called ZocDoc at a cost of about $250 per month. Nearly 85 percent of appointments made on ZocDoc are made by new patients. The service provides patient reviews of physicians on their site.

The day will probably come when physicians make themselves available to communicate with patients by e-mail in appropriate situations. This is more feasible under some payment plans than others. And then there are the issues of legal liability. I wonder if e-mail communications with patients become part of the patient's record. If yes, and this happens by automation, there may be some risk to patients in terms of making ungrounded information about themselves available to insurers in a way not interpreted by the physician. Patients may speculate about things in an office visit that the physician knows need not (and should not) be entered into the record. If medical services tend to move online those ungrounded speculations by patients may be more likely to become part of a patient's medical record. The value of a person's medical record is a function of professional choices about what is included. If the record becomes bloated with content that should not be included the next step is likely to be automated searching and summary services. Artificial intelligence is not to a place where this prospect is attractive. It seems to me the solution is for e-mail communications between physicians and patients not be entered into medical records automatically.

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