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Physicians Use Web for 'Virtual House Calls' - 2002-07-10


A small, but growing, number of U.S. physicians is using the Internet to answer patients' medical questions. Insurance plans are covering these "virtual house calls," because they improve health care and save time and money.

The Internet consultations are designed primarily for patients who want to get medical information without having to make an office visit.

Patients log on to a secure web site, provide a credit card number, and e-mail their physicians describing the medical issue they want addressed. Within a set number of hours, the doctor responds. The charge is a fraction of what an office visit would cost.

Ed Fotsch, the Chief Executive Officer of Medem, an online consultation company founded by the American Medical Association, says authentication is an important part of the process. "In other words, you have to know whom you are speaking to and the physicians have to grant privileges to communicate with their patients," he said. "And then the information that is sent is encrypted, so that if it goes to the wrong or unintended person, they can not unscramble it. And every communication on the network requires a log in and an ID."

Online consultations are not for emergencies, Ed Fotsch says. They are for non-urgent questions. "As an example: One of my kids had three ear infections and I wanted to know if I should consider having tubes put in his ears," he explained. "If so, why? If not, why? What are the other options? And what could I expect were I do decide to have tubes put in my kid's ear?"

Ed Fotsch says it is more convenient to use e-mail to answer those questions than it is to take time off work to visit a doctor.

Montgomery, Alabama allergist Alan Meadows says the convenience, and savings, works both ways. "It is expensive for me to have my staff answering the phone, whereas an online consultation is not a ringing telephone that has to be answered immediately," he said. "Patients request refills and request appointments online."

Dr. Meadows says the online service also enables him to monitor patients with chronic problems that are controlled by medication a patient with hives, for example. "His hives are stable but I need to check base with him, so we do an online consultation," said Alan Meadows. "I'll ask him the same set of questions I would ask him if he had come into the office, and then we are able to refill his prescriptions for another period of time."

Dr. Meadows says online communications have also enabled him to monitor the health of former patients working in the Philippines, and studying in Siberia.

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