eVisits continue their slow, steady rise

It’s interesting to be in late 2009 and see e-visits described as a “disruptive innovation” that “the medical establishment is fighting.” I first started working on e-visits almost 10 years ago, consulting to RelayHealth (then Healinx). It’s a sensible concept, fairly straightforward to implement, efficient, and effective for certain situations. Yet growth has been slow. Part of the issue is that it’s health care we’re talking about, where innovation tends to be retarded when it involves changing physician practices. Another, related problem is that there’s no great financial incentive for the physician or patient to make a change. Health plans that do cover e-visits often charge the same co-pay for patients as for in-person visits, even though they often reimburse physicians at a lower rate.

My guess is that over the next decade we’ll see e-visits become common. Why?

  1. Adoption will follow the typical S-shaped curve, and we’ll soon get to the steep climb almost regardless of other changes
  2. More patients and physicians will simply expect to communicate online, as they do in every other area of their personal and professional lives
  3. Payment systems will evolve to support e-visits, rather than penalize them
  4. Adoption of electronic systems in physician offices in general will enable e-visits
  5. Supporting technologies will evolve and emerge. These include remote monitoring, higher bandwidth, personal health records, and mobile applications

Enjoy the next decade and don’t expect things to change too quickly.

December 22, 2009

4 thoughts on “eVisits continue their slow, steady rise”

  1. I think more doctors would jump on the bandwagon if they realize that they could peddle more unnecessary drug prescriptions that way. Not to mention more money pharmaceuticals would make too.

  2. Ceebee, Actually I don’t think you’ve got it quite right. One of the reasons e-visits are cost-saving is that doctors prescribe fewer meds and tests than they would in an in-person visit for the same ailment.

    Often a patient feels they deserve a prescription after the hassle of coming in for a doctor’s appointment and the doctor goes along with it. With an e-visit that’s not the case.

    In the US, at least, doctors don’t benefit financially from prescribing drugs.

  3. At this current time eVisits are struggling to take hold, but I agree over time this type of service will be the de facto standard.

    One of the problems which gets overlooked is the high level of instability in the current healthcare environment. After the introduction of EMR’s the majority of physicians have become overwhelmed with technology in general. In my opinion clinicians have become overwhelmed, both due to poorly designed technology, but also because of the dramatic changes to their workflow that these technologies introduce. Now when administrators come along with this “new, exciting technology” clinicians are obviously reluctant to buy-in. Thus adoption of eVisits suffer as a result of this.

    Also the adoption of eVisits is highly dependent on the current physician compensation structure. Its difficult to convince physicians to use eVisits in a fee-for-service structure, when there is little to no RVUs attached to it.

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