The Government’s vision to create a Health Information Exchange (HIE) has the potential to provide a comprehensive patient history at the point of care. In addition to this data exchange, Internet and “meaningful use” of electronic health records will have a positive and significant impact on the delivery of healthcare and its associated costs. This new arrangement will improve the collaboration among providers and health facilities.  The integrated medical groups like Kaiser Permanente, the Mayo Clinic, the Cleveland Clinic, and University of Pittsburgh Medical Center are extensively utilizing technology to improve access.  These big groups are combining doctors, clinics, hospitals and often some insurance and capturing the financial savings from electronic health records.

However, despite all the benefits, adoption of technology is slow in most of the small practices.  It is surely a change in “status-quo”, and as such small practices do not get financial incentives to use computerized medical records and for some practices it is very time consuming process to convert paper records into electronic records.

“And there are privacy and patient centered concerns as well” said Dr. Donald Tavakoli; a Philadelphia based Psychiatrist. “Obviously for psychiatrists, mental health issues and therapy notes raise a major concern of “discoverability” and differ from the rest of medicine (at least in some people’s minds).  Not to mention, typing with a patient in front of you, which happens a lot with electronic systems, takes away from the doctor patient relationship.  On the other hand, legibility, access to records, and streamlining for billing purposes can increase efficiency and decrease redundancy in testing etc.”

Dr. Tavakoli said “technology being incorporated into practice is a good thing as it increases access (as DocAsap proves), increases efficiency, and decreases risk of errors.  And at the end of the day, it is inevitability.  Increasingly, I’m hearing about things like Ipad’s being considered as notepads for clinicians, which could offer simply touch screen checklist items to mark off during evaluations, this not only reduces medical error but healthcare costs as well.  And it is possible increased technology and Electronic record systems dovetails with increased “checklist” medicine.  The big concern is that in healthcare, sometimes the art of medicine can have immeasurable value, and the doctor patient relationship is crucial (and mental healthcare tops that list, especially with psychotherapy, but it is true in all of medicine).”

Please check Dr. Tavakoli’s profile at DocAsap

We recently came across an interesting article that discusses the challenges of locating the right information to help select a primary care physician.  Some interesting points:

• Determine if your insurance is compatible with the doctor’s practice.
• What is the doctor’s hospital affiliation? Is the doctor affiliated with a reputable, nearby hospital?
• How convenient is the doctor’s office to your home?

In the coming weeks, DocAsap will be launching with primary care, allowing you to find this information, and more, with ease.

We tell just about anyone we come into contact about DocAsap. When we first tell people about the idea of “doctor appointments at your fingertips”, the reaction of the listener most often starts, “Wow! that’s a great idea! I would definitely use a service like that!”  Then, as we get deeper into the conversation, the “yeah, but….” comments start to come out  (e.g. “yeah, that’s a great idea, but patients won’t actually book appointments online!”).  We love the objections, and want to respond below with data supporting the need for DocAsap.com.

Objection 1. Patients aren’t going to want to go and see just any doctor. They won’t switch doctors because they only want to see their own doctor!
In fact, a recent McKinsey study involving more that 2000 patients found that 2/3 of patients are willing to switch providers for improved scheduling and 77% would switch for more timely appointments.

Objection 2. Most patients already have strong relationships with their doctors and aren’t often looking for new doctors.
56 million Americans across all demographics of income, race, geography and insurance coverage do not even have a regular primary care physician relationship. Specialists relationship is even lower.

Objection 3. Patients here in the U.S. can’t just book an appointment to see a specialist, they need referrals.
First of all, patients with referrals will certainly be able to use DocAsap to book appointments.  In addition, from a macro-perspective, HMO enrollment continues to decline , falling 5.8% to approximately 44 million from July 2007 to January 2008. At the same time, PPO enrollment grew 4.4% to 110 million, increasing the number of patients who can book directly with specialists, without a stringent referral requirement.

Objection 4.  All doctors are overbooked and there aren’t going to be open slots available!
New and emerging practices and doctors are constantly looking for new patients. Even well-established doctors know that they need a certain fraction of total patients to be new patients in order to keep their practices thriving. In addition, surprisingly high cancellation rates reduce doctor utilization significantly. Anecdotally, in practices and clinics in the West Philadelphia area where we go to school, the cancellation/no-show rate is regularly up to 50% of appointments!

Objection 5. I can’t imagine patients booking doctor appointments on line, this is something that people only do over the phone.
Even without the benefit of statistics, we know that online appointment booking in general for major service sectors continues to grow rapidly. People manage a large percentage of their “offline” lives online, and we don’t see that trend reversing.

Let us know what you think! We appreciate more of your feedback on your service and we’d love to hear what you think of our responses.  Also, let us know if you have any additional data supporting the need for online doctor appointment booking.