A virtual visit to the doctor

Marketplace Staff Jan 19, 2007

TESS VIGELAND: It seems like we’ve been hearing for years now about the new era of digital medicine. Well, this week, a coalition of computer and health insurance companies offered new tools to encourage doctors to get on board and use electronic prescriptions. They just type them in and they go straight to the pharmacy. No more trying to decipher the chicken scratch. But as Helen Palmer reports from the health desk at WGBH, patients shouldn’t expect e-prescribing to take over anytime soon.

FRANKLIN TUCKER: I have been able to stay away from my primary care doctor for nine years.

HELEN PALMER: Franklin Tucker edits a couple of weekly newspapers in small Massachusetts towns. And he doesn’t like doctors.

TUCKER: I’m pretty healthy and I run marathons, but I have high cholesterol. So the only thing I really need is a prescription for Lipitor.

And that prescription he gets via his computer.

TUCKER: First of all, what I have to do is go online.

Tucker logs onto the website of Boston’s Beth Israel Deaconess Hospital, where his doctor works.

TUCKER: There’s something called a patient site. And if I remember my user name. And it worked. I remembered the password.

Once on the site, he checks for e-mail, say a reminder to get his screening. Or he can go to his list of meds and request a refill of his Lipitor be sent electronically to his pharmacy.

But that’s not the way most pills, even most refills, are prescribed in the U.S. Forrester research analyst Eric Brown.

ERIC BROWN: The e-prescribing rate in the U.S. is somewhere in the 9 percent range. The vast majority of physicians write a prescription on a piece of paper, hand it to the patient and the patient takes it to the pharmacy.

Brown says both doctors and patients like the exchange of that little bit of paper. So even though doctors can get tools to write electronic prescriptions for free, the real problem is getting them to change their old ways. It would be a huge business disruption.

Two-thirds of U.S physicians still work in practices with fewer than eight doctors. But the ones who use e-prescriptions love them. Franklin Tucker’s primary care doctor, Danny Sands.

DR. DANNY SANDS: What that allows us to do is write a prescription that’s checked for safety. In addition, we check these prescriptions for cost effectives so that when you get to the pharmacy, you’re not having to spend too much on your co-pay.

Sands is a thoroughly wired doctor. He wants to share the possibilities of e-health with his patients.

SANDS: If I’m entering information into your record and it’s the record that I keep, the electronic medical record that has your information in it, I can simply turn this around and share the record with you. And I think that’s a terrific, simple way to get patients involved.

Sands says he can link his patients to sites or programs to help them manage their health conditions. And, like his patient Franklin Tucker, they can access their medical record from their home computer.

But people have lots of different doctors and lots of different records. To pull them all together, you need another tool, the personal health record. Forrester analyst Eric Brown.

BROWN: If an electronic medical record is the electronic version of the paper record that your doctor had, a personal health record is something that you set up yourself and you self-report and self-populate.

For instance, it would have lab results and a diagnosis from your doctor. Then you’d add a list of your meds and your allergies, et cetera. Some doctors are pushing the importance of personal health records.

Kenneth Mandel works in the emergency department of Boston’s Children’s Hospital.

KENNETH MANDEL: Balancing accessibility of the information and privacy is the challenge. And we think that putting the information under the control of the patient helps to address that challenge head on.

Mandel says if you control your health record, you could decide which bits, say your employer could see. You might not want him to know you were treated for depression.

For now, only a few thousand more doctors will start to use e-prescriptions. And only a few tens of thousands of patients, like Rocky Grosso, will check out their own vitals.

ROCKY GROSSO: I was able to go and look at the report of how I did on my stress test. It was in Greek to me, but, eventually I guess the last paragraph said, oh, he’s fine. So it made me feel good.

Feeling good, improving health–isn’t that the point?

In Boston, I’m Helen Palmer, for Marketplace Money.

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