Health Business Blog

Health care business consultant and policy expert David E. Williams share his views

Electronic communication between doctors and patients

An article in this morning’s New York Times describes the move toward structured, electronic messaging between doctors and patients. (My client, RelayHealth of Emeryville, CA is featured prominently.)

For doctors, the convenience of online exchanges can be considerable. They say they can offer advice about postsurgical care, diet, changing a medication and other topics that can be handled safely and promptly without an office visit or a frustrating round of telephone tag. And surveys have shown that e-mail, by reducing the number of daily office visits, gives physicians more time to spend with patients who need to be seen face to face.

For patients, e-mail allows them to send their medical questions from home in the evening, without missing work and spending time in a doctor’s waiting room. In fact, many say exchanges in the more relaxed, conversational realm of e-mail make them feel closer to their doctors.

Some health plans are reimbursing physicians for these online webVisits. However they don’t quite get it because in many cases they still charge the patient the same co-pay as for an office visit, which discourages patients from trying the service.

“Patients love this stuff; I love this stuff; the staff loves this stuff,” said Dr. Barbara Walters, a senior medical director at Dartmouth-Hitchcock Medical Center in New Hampshire… “The intelligence of our patients never ceases to amaze me,” Dr. Walters said. “Patients can describe what’s going on with them, if given the chance and given the time.”

10 (or 20) hour wait for a bed at Mass General

The front page of today’s Boston Globe has a picture of stretchers lined up in the hallway because the ER is overcrowded. It’s what we might expect after a natural disaster, but apparently this is business as usual at Mass General Hospital:

Typical is the situation recently at Massachusetts General Hospital… It was 1:30 pm on Thursday, and 20 patients in Mass. General’s emergency department needed to be admitted to the hospital for more extensive care. But the hospital had beds for only eight new patients. The electronic chart listed how long patients had been waiting for beds on a medical floor. The longest: two patients for 21 hours and one patient for 22 hours. A half-dozen recent arrivals were parked temporarily in hallways.

In classic fashion, hospital administrators say they’re doing all they can and need more capacity. Some hospitals in Boston are adding beds. Deep in the article there is a reference to Eugene Litvak, professor of healthcare and operations management at Boston University. He believes the problem is poor planning and I think he’s mostly right.

We wouldn’t expect factories to simply add new, expensive capacity as a first resort every time demand increases, and we shouldn’t expect it of hospitals either.

Welcome to health business blog

In this blog I will offer my perspective on business issues in health care. I’ll focus on topics I’m passionate about, including customer service, productivity, and quality. I’ll bring my experience as a strategy consultant at MedPharma Partners and as a user of the health care system.