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Elizabeth Cooney is a health reporter for the Worcester Telegram & Gazette.
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Wednesday, June 13, 2007

The revolution will be e-mailed

A quiet revolution in health care has begun with the growth of secure e-mail communication, Dr. John H. Stone writes in tomorrow’s New England Journal of Medicine.

"The 'laying on of hands' will increasingly include the pressing of keys," he says in an opinion piece.

Web visits in which doctors answer patients’ non-urgent questions aren’t the only services e-medicine can enable, he said. He describes a transition that came about at his clinic in part as self-preservation in the face of round-the-clock contacts flooding office, clinic and home phones and fax machines.

Stone directed the vasculitis center at Johns Hopkins until recently becoming deputy editor for rheumatology at UpToDate, a subscription-based provider of clinical information in Waltham. He will soon resume clinical work part-time at Massachusetts General Hospital.

Appointment scheduling, prescription refills, and messages about routine issues (such as whether an X-ray is needed before a visit) were moved to e-mail.

"In time, secure e-mail communication among patients, physicians, and medical centers (hospitals, emergency rooms) will become the norm, because it is efficient and makes sense," Jones said in an interview (by e-mail).

His clinic had to overcome concerns about privacy and security and get around compatibility issues for e-mails to become part of the patient’s record. And even if patients were frustrated by the trouble they had reaching their doctors by telephone, they weren’t necessarily ready to pay for Web consultations, which Stone says cost from $10 to $25. Physicians need to be compensated in order for this kind of communication to be a success, he said.

"The extra effort cannot simply be added on to the rest of their work day (and evening)," he said.

The payoff comes not only in convenience, but also in safety, he argues. E-mail between doctors, hospitals, pharmacies and other parts of the healthcare system have the potential to improve medical care by bridging gaps between them.

In a health policy report also appearing in this issue, Dr. David Blumenthal and John P. Glaser of Massachusetts General Hospital discuss the implications of health information technology for doctors, patients and the healthcare system.

"Implementing HIT (health information technology) nationwide will require changing, quite dramatically, the work of millions of health professionals and tens of thousands of institutions throughout our $2 trillion health care system," they write. "In the face of this challenge, the will to improve will be primary, the technology itself secondary, and patience critical."

Posted by Elizabeth Cooney at 05:31 PM
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