Software

Leveraging the Internet to provide patient care

Dr. Howard Stark moved his private practice from his original base in Washington to the Internet. Answering 14,000 e-mails since his online practice began two years ago, he is less a harried doctor and says he feels more like a small town family doctor.

Dr. Howard Stark moved his private practice from his original base in Washington to the Internet. Answering 14,000 e-mails since his online practice began two years ago, he is less a harried doctor and says he feels more like a small town family doctor.

Dr. Stark’s practice allows him to provide answers to questions that used to be managed through phone calls and office visits. Through the use of e-mail, he feels he is better able to maintain a personal bond with his patients.

As reported at about this time last year, doctors were beginning to switch to the use of electronic prescriptions via the Web. Web-enabled prescriptions allowed for fewer errors in medications and dosing. At that time, the question was raised as to how much patient care would be provided via new technology as it became available. And how much would be too much, leading to degradation of patient services. Dr. Stark may be pushing that envelope.

From Reuters:

He does not charge for answering an e-mail. "You have to come in one time a year for an annual exam," Stark said.

The rest is free -- prescription refills, quick questions about medication, even questions about unusual stings.

"What do I get? A picture of the scorpion that bit the patient in Belize," Stark laughed. "I said, 'it would have been better to send me a picture of your leg.'"

Dr. Stark believes that the demand for a doctor’s time is being pushed to the limit. Desk staff are double and triple booking the doctor’s time, and the time that the doctor is able to spend with the patient averages ten minutes.

Working part time and leveraging technology, Dr. Stark is able to spend at least a half hour with each patient.

Patient security is managed through the use of a unique Web site designed by Dr. Stark and a couple of friends called DoctorsOnTheWeb.com. Through this site, any doctor can manage his or her practice as Dr. Stark is doing. And so far, three other doctors are signed up to use the site.

More from Reuters:

The system works like a bank's Web site. To avoid putting confidential information in e-mails, patients work on a secure server. If Stark wants to contact them, they get an e-mail merely directing them to pick up a message at the password-protected site.

It allows patients to ask about their health as issues arise, instead of waiting for the annual exam. "If you have any questions, it's so nice to shoot an e-mail," Stark said.

He can direct patients to the emergency room, if appropriate, to see a specialist or set up an appointment for an examination. Stark stresses that he does not make medical decisions based on an e-mail.

But no one has to wait until business hours. "I'll refill your prescription from Barcelona," he said.

So, is this the wave of the future? I can think of many times that I have had to make, and pay for, an office visit just so a doctor could tell me that whatever I had been treated for is resolved. As a former ER nurse, I can recall numerous times that people spent many hours in Emergency for something that could have been resolved by phone. Is electronic medicine the right way to go, or are we trusting too much to technology?

8 comments
contact
contact

For people residing in more rural areas this is a great thing, in my region local doctors are getting scare and people have to travel long distances to get some care, an email can provide some timely reassurance. Staff, HealthcareReviews.com

seanferd
seanferd

but there is quite a bit of potential for abuse, as in not physically seeing people when necessary. Also, I know a few people who have enough trouble with doctors becoming unavailable by changing practices. What happens when the standard becomes medical care through e-mail? Will there be a new premium for folks who need to visit a doctor for real? All that said, I still think that this is a good extension of medical care. I just hope that any other doctors following this path stick to this fellow's model.

Tig2
Tig2

The whole patient privacy issue must be addressed in some manner. HIPPA demands that. We have long said that in order to care for the patient, you must listen to the patient. E-mail forces that by its nature. I can see this model leading to improvement in patient care- possibly significant improvement.

meryllogue
meryllogue

I research on the 'net. I also email my doctor about smaller things. Sometimes she gives me a short answer and tells me I am asking for more information than she can give in an email. I then make the decision to go in, or to do more research on my own. She also answers questions about my prescriptions, or does refills, although I am not clear yet if it is better to call her nurse or email. It would be nice if she felt comfortable with this, and clarified her limits. Nice article, Tigger, and I will pass it to my doctor.

Tig2
Tig2

Is this the wave of the future? I can think of many times that I have had to make, and pay for, an office visit just so a doctor could tell me that whatever I had been treated for is resolved. As a former ER nurse, I can recall numerous times that people spent many hours in Emergency for something that could have been resolved by phone. Is electronic medicine the right way to go, or are we trusting too much to technology?

santeewelding
santeewelding

The instructor is an RN of 30+ years. I fawn over her every extemporaneous advise, the habitue that she is, my sole link that she is. My impression of her first foray is that she reigned of old, does so hesitatingly now with respect to IT, and urges that we embrace what is to come. Charting in real time, for instance. Security. Screwups. Et ali. I now begin myself. Had to finally manipulate OO.org for real to report on our field trip Monday to "Bodies...The Exhibition."

santeewelding
santeewelding

I'll try to let you know what I find. If I last it out to succeed (>EMT), I may lean on you in future for help, given your background and foreground. Computer lab is week after next.

Tig2
Tig2

EMT, especially in these days of increased technology is a real job. Any emergency medicine is. But I have faith in your ability to do a fantastic job! It is a calling- not everyone can handle Emergency and First Response. Let me know how you are doing! Edited to add this PS: I went to nursing school at Grossmont...