Virtual medicine

[Scroggie]

How may folks here are using email or web-based tools to deliver care?

My email address is available to most of my patients (centralized military database) and I have more than a few who email on a regular basis for questions/refills et cetera. Saves time to answer back on email.

Anybody tried billing for it?

What about security?

[BigDoc]

Medem.com (http://www.medem.com) has a free service you can use for secure email and bill for the service. Their servers store all the messages to ensure security.
Relayhealth (http://www.relayhealth.com) has a similar service, don't know whether they charge for it. I'd be interested to hear if anyone charges, and gets paid :rolleyes:

[Kursk]

Daniel Sands as Mass General has spoken on this a lot. He gets about 3 emails per 1000 patients per month. Healinx/Relay health have several demonstration projects that have been published and they work on a fee basis (patient can be charged or fee waived by MD). The Blues have been paying on the Left Coast and I think some on the Right coast as well. There is a code to charge. I have been encouraging patients to sign up with Medem, but only about 10 takers over last year or so, very few messages. I am more interested in things like PhoneTree or similar solutions in which the patient calls back in to an automated server for test results (message can be personal or canned, your preference.

[ozzie]

Medem.com (http://www.medem.com) has a free service you can use for secure email and bill for the service. Their servers store all the messages to ensure security.
Relayhealth (http://www.relayhealth.com) has a similar service, don't know whether they charge for it. I'd be interested to hear if anyone charges, and gets paid :rolleyes:


There is an open source repository out there for reporting human rights stuff which could be hacked to do the same thing.. Same idea the user /patient determines who sees what and when..

One day I will track it down and set it up ..

[Cardiodoc]

The British Medical Journal (www.bmj.com) dedicated its May 15 issue (vol 328 Nº 7449) to electronic communication and healthcare.

Check it out... :D

[witchdoc]

The British Medical Journal (www.bmj.com) dedicated its May 15 issue (vol 328 Nº 7449) to electronic communication and healthcare.

Check it out... :D


Almost all General Practitioners in England prescribe electronically

[ozzie]

http://bmj.bmjjournals.com/cgi/content/full/328/7449/1143 thats a decent summary ,,
But dont forget that the British system is really a one payor system so it should be far easier to use / make work that the multi medusa we have here in the US

[Kursk]

Yes 95% british prescribe electronic but they apparently lack any decision support - no interaction checking, disease - medication checking etc. So 50% reduction in errors but mainly legibility types. So they have a fairly primitive system so far, which should hopefully improve as their national EMR rolls out.

[ozzie]

Yes 95% british prescribe electronic but they apparently lack any decision support - no interaction checking, disease - medication checking etc. So 50% reduction in errors but mainly legibility types. So they have a fairly primitive system so far, which should hopefully improve as their national EMR rolls out.
I think it's important to note that a single EMR system may work but it should not be used as yard stick for our needs in the US .
I am sure the VA have system that would be akin to a single EMR system but would it work rolled over the private practice.. So that would mean the 95 % prescribe in the VA electronically for example but that result really means nothing in our biggger picture. I don't know how the drugs are distributed in the UK but the distribution method pays a big role in the electronic script process
I have never seen or used the system but I would bet bag of hanover cracked mustard pretzels it would not be suitable for a small practice..
The key is to use these master systems as guide and learn from that .. But be carefull using systems like this as the ultimate model..
You may get what you wish for .. LOL

[MHDoc]

The UK general practitioner has a much smaller formulary than the US physicians, and they do not have the litigation pressure physicians and pharmaceutical industries operate under in the US

[EMRhelp.org]

Yes 95% british prescribe electronic but they apparently lack any decision support - no interaction checking, disease - medication checking etc.


Can any MDs / pharmacists in the UK confirm this. I find it extremely hard to believe.

The data is _IN_ the computer and not checked for interactions ?

WOW !

[Kursk]

Make that poor interaction checking instead of "none".

http://www.health-itworld.com/enews/05-27-2004_195.html
http://bmj.bmjjournals.com/cgi/content/full/328/7449/0-c
http://bmj.bmjjournals.com/cgi/content/full/bmj;328/7449/1172

[ozzie]

http://bmj.bmjjournals.com/cgi/eletters/328/7449/1171#59933

some interesting results and replies

but more revealing woudl be what do your systems show ????