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.