Although the use of electronic communications by some physician practices has led to improved efficiency and patient satisfaction, widespread adoption of such technology remains elusive, according to research published this week in Health Affairs.
For the study, researchers from Weill Cornell Medical College in New York spoke with leaders at 21 medical groups--as well as staff for six of those groups--all of which use electronic tools to communicate with patients "extensively." By and large, patient satisfaction and workflow improved for the facilities, with several respondents touting the efficiency of sending emails to patients.
Still, use of such technology created more work for the respondents, as well, according to the researchers. "There's no end to it," one respondent told the researchers. "This has allowed us to work all the time."
In addition, respondents cited three barriers to widespread adoption, including:
- Patient resistance to change: Despite some reported improvements to patient satisfaction, other providers said that several of their patients were inexperienced with computer use and email.
- Physician resistance to change: Not all physicians initially were on board with using such technology, the respondents said, and the added workload is clearly seen as a disadvantage.
- Lack of a payment model: Only one clinic charged patients for email that involved clinical decision-making--this group negotiated reimbursement for e-visits with private insurers and patients paid a copayment. Another clinic tried charging a $60 annual fee for unlimited electronic communication, but later dropped the charge because competitors provided the service for free.
"Despite the fact that we found experiences with electronic communications were, on the whole, very positive in the groups we studied that have embraced this technology, we believe the big stumbling block to its widespread use around the country will be compensation," lead author Tara Bishop, an assistant professor in the Departments of Public Health and Medicine at Weill Cornell Medical College, said in a statement. "Until different payment models emerge, electronic communication is unlikely to be widely adopted by physician practices."
Fewer than a third of physicians reported they exchanged secure email messages with patients in 2012.