What is is interesting is that for some reason people think that using telemedicine will save money by cutting down the time for doctors versus an inpatient visit and according to this report that holds no water at all; however the use of mHealth efforts combined with in office visits certainly seems to be having a positive impact on care for the good.  It’s all about being better educated and informed for both the doctor and the patient.image 

The various technology tools took 6 years to grow to where they are now and at the same time they had other changes in procedures and technology in other areas that were not mHealth but rather may have touched some of the technology services with the line of care.  Again it’s the same person, the doctor whether it’s in person or as the “desktop medicine” function still needing time either way.  Overall the message in this article is that savings are slow to show up which is basically pretty normal but in the “instant” world we live in today people don’t associate the fact that mHealth still takes time.  They do low tech solutions too as well as high tech.

Kaiser finds some Low Tech Solutions Along With High Tech

The study was completed in northern California for the report.  So you can forget all the financial hoopla you read about big dollars being saved as we are still humans moving through the system.  Sure there are things like being able to get your lab reports online when you are home saves time instead of having another visit or having a nurse tell you, but one is available to discuss, but again how do you “really” measure that?  You can’t but you know there’s time saved and for those in the world today that want “everything” quantified, well life is going to be even more frustrating as there’s a lot you can but you can’t tie dollars to every minute of the day, as people don’t work that way. 

Mayo Clinic pretty much said the same thing with their study, in the fact that putting in a patient portal has zero impact on face to face visits, patient still came in for care when they needed it and perhaps they should have looked a the care side and maybe they did, but wasn’t mentioned in the article.  I thought it was funny too as I read folks commenting that this was a failure as far as “saving money”.  Again that goes to show you where people’s heads are at sometimes.  e-Patient Dave and I chatted a tiny bit about it too and he was kind of surprised too that “folks thought putting a portal in place was going to save a lot of money” at Mayo.   What we both agreed on though is that mHealth and portals when used do help with care and communication, again that gets over looked as everyone seems to think it all has to save a buck as a first priority.  Care and information is the real name of the game here.   BD

Mayo Study States “E-Visits” Via Patient Portal Has No Impact on Face To Face Visits, But We Can Stop With the Money Saving Projections For Now Anyway-Humans Still Like Humans And More Work on the Model Might Be A Good Idea

Robert Pearl, MD, executive director of the Kaiser Permanente Medical Group, points in a report to the benefits of integrating mobile technology into all levels of a healthcare delivery system.

A secure e-mail service allows users to attach images (such as a digital picture of a rash, for instance) in a message to a Kaiser dermatologist. In 80 percent of those cases, the dermatologist was able to offer a definitive diagnosis and prescribe without an office visit.

A mobile service targeted at Kaiser patients scheduled for surgery includes self-care information, answers to common questions about the surgery and video coaching from doctors to patients who are experiencing difficulties before or after surgery. In all, the service resulted in one fewer in-person visit per patient than occurred among those who did not take advantage of these systems.

The suite of Internet, mobile and video tools designed by Kaiser is delivered to 3.4 million members, 8,000 doctors and 21 hospitals in northern California. Launched in 2008, it grew from 4.1 million virtual visits to the 10.5 million visits in 2013.

In that report, “Kaiser Permanente Northern California: Current Experiences with Internet, Mobile and Video Technologies, (The Kaiser Report),” Pearl doesn't shy away from the challenges yet to be overcome in Kaiser’s delivery system. And all the claims are backed with stats from independent studies.

What’s more, the Kaiser Report notes that it took six years of “concentrated effort” to increase online registration from 20 percent to its current 73 percent level. Also, while virtual visits are initially less expensive than office visits, they still require physician time and, often, a follow-up office visit.



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