Doctors like using e-mail about as much as their patients like getting shots.
Just ask Pat Camalliere, who launched a Web site that invited e-mails a few years ago at the surgery practice she manages.
“We had someone checking e-mail, but you’d get one real message every other day and about 95 spams,” said Camalliere. “It was a catastrophe.”
Despite advancing technology, medical practices have proven remarkably resistant to embracing e-mail as a tool to correspond with patients. Physicians regularly order medical tests and image scans that use high-tech electronics, but when it comes to patient communications they still prefer the phone.
E-mail raises concerns about patient privacy, legal liability over miscommunications and the failure of most insurance providers to pay doctors for time spent answering e-mails.
“Just adding technology won’t help a physician’s practice unless he also changes his processes,” said Lorraine Fernandes, senior vice president for health-care practice at Initiate Systems Inc., a Chicago firm that provides information technology assistance to the health-care industry.
“Information technology and e-mail are used more widely by large [doctor] groups like Kaiser that have a depth of technology resources,” she said. “But most physicians practice in groups of five or fewer and they just don’t have those resources.”
Still, physicians are spending a lot on new technology. In 2004 a study by market research firm In-Stat found that small and medium-size health-care organizations spent a total of $21 billion on information technology services and equipment. In-Stat projects that by 2008 that total will reach $27 billion.
“Younger doctors and nurses especially are used to using PDAs, laptops and smart phones,” said Stephanie Atkinson, a senior analyst at In-Stat. “Wireless systems are especially useful to physicians who are often out of their office.”
But Atkinson doubts that physicians will ever embrace e-mail because it is time-consuming for them to sort the urgent messages from the mundane.
While lawyers, accountants, consultants and other professionals are among the most enthusiastic users of e-mail in the business world, physicians will probably always require nurses or assistants to look through e-mail for them, Atkinson said.
Chicago-based NeedMyDoctor is taking the approach that someone else is better suited to handle a doctor’s e-mail.
The system routes messages to the physician’s answering service. Operators handle e-mails just as they would phone calls–contacting the physician immediately for urgent matters and sending the rest to the office for normal processing by staff.
“It relieves anxiety for patients who hate to be put on hold and leave voice mail messages,” said Joseph Sameh, president of NeedMyDoctor.
Lisa Reardon, a Glendale Heights resident, has been using e-mail for almost a year to contact her doctor.
“I hate to call them on the phone,” she said. “You get this recorded menu. `Push this, push that.’ You get put on hold and then go into voice mail. E-mail is much easier.”
She also likes the convenience of sending a message at any hour, knowing the physician’s staff will get it.
The NeedMyDoctor service adds less than $1,000 a year to the answering service fees of a typical practice, said Sameh, adding that some physicians find that it reduces expenses.
“We get hundreds of phone calls a day to our office,” said Dr. Ira Goodman, an interventional pain specialist practicing in Burr Ridge. “It takes much less time for a staff member to read an e-mail than it takes to listen to a voice mail.”
Usually the e-mails concern making appointments or refilling prescriptions, Goodman said. Sometimes they bring information about a patient’s changing condition, and he wishes that more patients used e-mail that way.
Dr. Pam Eernisse, who has a podiatry practice on Chicago’s North Side, said her first experience with e-mail didn’t work because she didn’t have time to check it regularly.
“Patients weren’t getting prompt responses,” she said.
Sameh started offering his service in early 2003 and now has about 30,000 physicians using it, including 2,000 in the Chicago area.
He thinks the service could double as an early warning system for public health officials.
“The way public health agencies track epidemics now is after the fact,” he said. “Patients visit their doctors and are diagnosed. Information is forwarded to public health authorities so they may learn some days after it’s happened that a given community has a flu epidemic.”
If enough people begin communicating with physicians via e-mail, software could scan the e-mails and alert authorities if there is an upswing of certain symptoms in a community, Sameh said. The software would scan e-mail appointment forms to search for symptoms such as fever, chills, coughing and so on.
“You could forecast infectious disease outbreaks in the same way they forecast the weather,” he said.
Sameh has taken the idea to several area hospitals and hopes to launch a pilot study here later this year.
Nonetheless, for most patients, e-mail is just a helpful way to avoid voice mail misery when they need to reach their doctor.
Gail Fentress of Calumet City used e-mail to reach her physician–until she changed doctors. “My new doctor doesn’t have it,” she said. “If she did, I’d use it.”
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jvan@tribune.com
