You bring up an important point I did not mean to skip over–Kaiser Permanente is an HMO at its core. This means I am not reimbursed for each thing I do, but rather on the basis of taking care of my patients. So it is somewhat easier for us to provide email access than it might be for a pediatrician in private practice who is reimbursed differently.

On the other hand, the market place is changing rapidly, and more and more of KP’s business will be based in self-funded insurance in the future. So we will need to demonstrate the value of providing email access, if we want to be reimbursed in the future.

There is no doubt in my mind that we provide great value to our patients and to their employers with this service. We are working to be able to demontrate that value to the employers as well!

As far as the issue of incomplete information goes, I think it is mostly a matter of learning how to use the medium. At one point, all medical care was based on the face to face transaction. When telephones became available, we learned to use them. I think email is the same. We need to develop a level of comfort. This is easier with people you know. Sometimes we can’t get the picture we need to have to make a good decision on line. There is no reason we can’t switch to the phone at that point. But I think many people have the idea that when we introduce a new technology, it supersedes the old one. That is absolutely not the way we should use email–email should augment the older technologies, but we should never stop using our good judgment, either as patients or as providers.

Mark

I think this is a progressive approach and good to see Kaiser enabling this. Much like clinics, I think that e-visits and e-mail have a place in today’s society. It would probably be possible to do video consults on some issues also to minimize disruption for small issues.

I know whenever I need to reach our pediatrician that it might take her 4-5 calls to get back in contact with me due to my schedule.

Most physicians seem very worried about e-mail both from another task to take on, not getting reimbursed, and lack of information leading to a mistake. I have to believe there is a way to change this.

George

P.S., Trying to think about patients from a health company perspective is what my blog (Patient Centric Healthcare) is about at http://www.patientadvocate.wordpress.com.

Thanks! Since I have 2 job roles, I am not in my clinical office every day. Having email also helps me be available to my patients even when I am not there, which is another thing I like about this.

When we first started doing email, many providers were worried that they would be overwhelmed by emails, and that they would include a lot of spam. It turns out, of course, that our patients value having this kind of access, just as you would. Most of the emails we get are very concise, and our patients are very respectful of the physician’s time. I suppose having this kind of access really is extraordinary in some ways. To me, it feels like the most natural thing in the world.

Mark

What a powerful example of how valuable these tools can be for empowering consumers and enriching the clinician-patient relationship if used thoughtfully!

As a parent of three young children, I am envious of the access the parents of your patients have to you.

Thanks for sharing.

–Josh