In the News
GETTING HELP | Secure Web sites allow patients to contact docs, and some insurance companies are paying for online consultation
March 25, 2008
If you've ever called your doctor's office to set up an appointment or ask a question, you've probably been there: Waiting on hold for what seems like forever, just to get a rushed response from a doctor or assistant trying to squeeze you in between other patients. Or worse, playing phone tag for two or three days.
An e-mail to the doctor's office could save you the hassle. But doctors have been reluctant to use the Internet to communicate with patients because they're worried that e-mail would add to their workload and compromise patient confidentiality. 
When Ren Freeman of Evanston couldn’t reach her doctor by phone after three days of trying, she turned to needmydoctor.com.
But doctors and health-care companies are slowly coming around, with the help of secure Web sites that allow patients to ask questions, get test results and schedule appointments online instead of by phone or in person. And some insurance companies have started reimbursing doctors for online consultations.
"These days, in society, almost everybody uses e-mail. It certainly makes sense that we would . . . with our doctors," said Dr. Lyle Berkowitz, medical director of clinical information systems for Northwestern Memorial Physicians Group. More than half of the group's 80 physicians use a system called RelayHealth to communicate with patients online. RelayHealth is more secure than regular e-mail because patients must verify their identity, and messages cannot be read en route, copied or altered.
For a fee, patients with non-urgent medical conditions, such as the flu, may also request a "webVisit." This involves filling out a detailed questionnaire -- with the types of questions a doctor would ask during an office visit -- which then generates a report that is sent to the doctor. Many times, patients who have been "seen" during an online consultation don't need to schedule an appointment, Berkowitz said. And prescriptions or refills can be sent by the doctor electronically.
The American Medical association has a similar service called Medem.
NeedMyDoctor, a Chicago-based Web site, routes electronic messages from patients through the 24-hour call center of the doctor's office, allowing doctors to receive messages by pager, fax, phone or e-mail. If it's urgent, the doctor is contacted immediately, just as if a patient left a voice mail message with the call center.
Ren Freeman, of Evanston, used NeedMyDoctor for the first time when she developed a sinus infection over the Christmas holiday. After trying for three days to get her internist on the phone, Freeman reached out to another doctor using the Web site. "I did it, never expecting to get a response as quickly as I did," she said.
Within 15 minutes, she was on the phone with a sinus surgeon. "I was amazed, frankly. That saved me from having to go to the hospital," she said.
The Web is a convenience for patients, but doctors who use the Web say it improves their bedside manner, so to speak. "When you call and you want to know something, we have to run around looking for your chart. If we know what the question is ahead of time, by the time we make voice communication, we have a response for you, not just 'wait on hold again,' " said Kelly McDonald of Nephrology Associates of Greater Illinois and Indiana.
NeedMyDoctor user Dr. Dale Gray said: "The people that I know that use it regularly ... feel more connected because they've had more communication with me than they would have otherwise."
One can imagine nightmare scenarios where urgent messages about severe medical problems go unread for hours or days in a doctor's inbox. But these instances are rare, doctors say.
This year, Aetna and Cigna began reimbursing doctors nationwide for RelayHealth webVisits -- a move that may encourage more health-care professionals to embrace online communication. Another incentive: a recent survey found that nearly 40 percent of patients would pay for secure e-mail access to their doctor and change doctors to get such access.