BUSINESSWEEK ONLINE : DECEMBER 11, 2000 ISSUE
BUSINESS WEEK E.BIZ -- SPECIAL REPORT One Doctor's E-Health Checkup Dr. Peter Basch on how Internet services can improve patient care -- and why more physicians aren't making the leap Dr. Peter Basch is an internist at Washington Primary Care, a four doctor practice in Washington, D.C., and an ardent believer in the Internet's power to transform health care. Basch routinely interacts with patients via e-mail and uses computer software designed by two e-health giants, Medscape and WebMD. Basch's early adoption of the Internet makes him an anomaly in the medical community. According to recent studies published by Modern Physician and Cyber Dialogue, only 3% of the 600,000 doctors practicing in the U.S. routinely e-mail their patients, and only 21% currently use computer-based medical-records systems. In a recent interview with Business Week Science Editor Ellen Licking, Basch discusses the potential of Web-based technology to improve medical care -- and why so many doctors remain unconvinced of that promise. Edited excerpts of their conversation follow: Q: Why aren't physicians, for the most part, using the Internet in their practices? A: There are a number of reasons for why doctors don't seem excited, let alone interested, about the Internet. The first reason is time. To a busy physician, the intrusion of computers and the Internet seems like one more thing that will eat up precious time. We think of patient visits in terms of minutes and pharmaceutical salespeople in terms of seconds. Physicians live by the maxim: "If you can't show it to me in 30 seconds or less, I don't have time to hear about it." That doesn't leave any time to explain to doctors how computers and the Internet can transform our profession. The second reason is the perception of brokenness. The American public, economists, and politicians harp that the U.S. health-care system is in shambles. Doctors see a problem too, but a very different one. Physicians believe it is the other side of medicine -- the business side -- that is broken. Most physicians are too busy too think about that side and delegate it to their office personnel. Finally, technology solutions must work well all the time. My prescription pad has never let me down. Name one computer or software program that has never crashed. Q: In what way is the business side of medicine broken? A: Managed care has created a whole level of inefficiency that physicians spend half their time trying to satisfy. Searching outdated directories and paper-bound formularies for the right drug to prescribe to your patients -- that's grunt work. At the same time, there are more and more forms to fill out and decreasing reimbursements for the services you provide. Q: But wasn't the software developed by WebMD supposed to solve this problem? A: WebMd's software is supposed to shorten the period between when a doctor submits a claim and gets paid for it by the insurer. But most doctors say, "So what?" Claims reimbursement is not the main problem. The real problem is time. To make up for what I have lost in reimbursements, I have to see more patients in the same amount of time. And somehow, I have to do that without shortchanging the patients that are counting on me. Q: So what's the solution? A: Doctors really need so-called "point-of-care" solutions that automate the medical paperwork associated with a patient's visit. If a piece of technology lets you see more patients, but doesn't take away from the quality of the visit, then you have a winner. I am a big believer in electronic medical records [EMR], like the ones offered by Medscape. Q: Please describe how Medscape's EMR has improved your ability to be a doctor? A: Two years ago, I did a study of my performance pre-EMR versus post-EMR. I found out something alarming. Before I started using the computer-based record system, I spent only one-third of a typical 15-minute office visit examining the patient. But once I switched to an electronic medical record, MedicaLogic automated much of the paper work I had to fill out. As an internist, I see lots of patients with flu or diabetes or hypertension. But there are only so many ways to describe these symptoms. With this computer software, I can capture that information in a few keystrokes. I actually found that by switching to an electronic medical record, I could actually spend more time talking to my patients -- at least two or three more minutes -- despite the fact that I reduced my appointments to 10 minutes. Q: Is there any danger that the Internet could drive a wedge between you and your patients? A: No. One of the other things this software does is automatic drug-drug interaction look-ups. Patients love the fact that I am using a tool that could prevent dangerous medical errors. I've also found that the computer and the Internet can be useful learning tools. For example, when a patient with diabetes comes in for a checkup, I can use the software to quickly chart the patient's blood sugar so she can see how well she has been doing since she started her diet. Or if a patient comes in with a bunch of articles from medical Web sites, I can do a quick Web search of my own and recommend preferred information from sources I trust. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ BACK TO TOP					e.biz Contents for Dec. 11, 2000 issue RELATED ITEMS Curing an Industry's Ills TABLE: Patients Want Health Information Directly from Their Doctors.... TABLE: ...But Most Doctors Don't Deliver the Goods Online... TABLE: ...So What Are Physicians Doing on the Internet? CHART: Hospitals and Pharmacies Are Processing More Health Claims Electronically...And Doctors' Offices Are Finally Starting to Catch Up ONLINE ORIGINAL: One Doctor's E-Health Checkup INTERACT E-Mail to Business Week Online

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