The Life Ledger

Fitness is a way of life.

photo credit: john-norris

I recently read an interesting article on Medical News Today reporting health insurers will begin covering online physician visits:

Health insurers Aetna and Cigna have announced that they will pay for online physician visits, and patients will be required to contribute a copayment for the visits, the Philadelphia Inquirer reports. Aetna on Jan. 1 expanded a pilot project in California, Florida and Washington state to the rest of the country, and Cigna said it would begin paying for online visits in January 2009. The insurers believe that members will like the service because it can improve efficiency and could prevent more costly problems, the Inquirer reports.

Of course, my initial reaction is - is anyone actually offering online physician visits? Apparently so, if heavies like Aetna and Cigna are getting in the game. Physicians don’t (typically) obtain technology degrees or have the programming skills necessary to open up their practice to an online community, so the first step is supplying physicians a “web visits” framework. Cigna and Aetna both partner with RelayHealth, a company that enables “web visits” through services including online medical chart storage, online appointment scheduling, automated interviews that serve to triage the patient before communication to the physician begins, online prescription center, and a payment/collections/insurance filing center. RelayHealth maintains an entire page describing the benefits and features available to patients, which can be summarized by these two FAQ answers:

What is a webVisit®?
A webVisit is an online consultation between a doctor and an established patient about a non-urgent healthcare matter. When conducting a webVisit, RelayHealth guides you through an interactive interview process appropriate for your specific symptoms, and then builds a succinct message to the doctor based upon the answers you provide.

How do I send a message to my doctor using RelayHealth?
Once you successfully register with RelayHealth and your doctor agrees to communicate with you through the service, easy-to-use, structured templates allow you to consult your doctor about specific health symptoms (we call this a webVisit consultation), request a prescription refill, request appointments, receive lab or test results, ask a simple question, or access health education information — depending on the types of RelayHealth services your doctor offers.

Apparently, companies that assist in enabling physicians to offer medical services online are stating to sprout up. But are any physicians actually offering online services? Recently, ReadWriteWeb reported on the Health 2.0 conference, part of which was dedicated to the “web visit” phenomenon:

Jordan Shlain founded the San Francisco On Call Medical Group, a group of doctors who make house calls almost anywhere their patients want to see them (home, office, even cruise ships) using a souped-up, hi-tech version of the doctors’ venerable black bag.

Jay Parkinson is aiming to be the “small town doctor of Brooklyn ,” using video camming, text messaging, email and chat to help treat his patients.

Both Jordan and Jay showed how different the standard model of health care can be — but also revealed the huge gap between the existing system of health care and the state-of-the art technology that potentially could be harnessed to serve patients at an ordinary level. In the end, this gap is the core dilemma facing the Health 2.0 efforts to transform the industry.

We’ve come a long way from using the Internet to display office hours and send X-rays to other countries for analysis. It appears that soon, patients will have true 24-hr access to non-emergency health care. Add Second Life to the mix, and things get even more interesting - take, for example, this Flickr slideshow demonstrating some interesting possibilities. And soon, with services like Carol getting a start, we may have access to a-la carte style healthcare, where patients purchase “care packages” and receive the care at any participating location.

With all these changes afoot, the real question is - will patients use the services? What about you - are you excited by the possibility of receiving healthcare with an instant-messaging client and web-cam, or will you always expect on face-to-face treatment?

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It began with WebMD and similar sites - patients started trusting and turning to Internet resources for medical information. Once patients began coming to the doctor’s office prepared with Internet-based diagnoses and medicine requests, doctors started paying attention to the Internet as well. Fast-forward to the present - not only do patients frequently turn first to the Internet for medical information before calling their doctor, they are now organizing into social networks like Wellsphere, DailyStrength and iMedix. We recently learned from sources like Mashable and TechCrunch that Internet heavies like Google, Microsoft and AOL are setting up systems for storing health records. And now, doctors are apparently getting into the scene with social networks and blogs of their own.

Digg recently directed me to this story at NPR about doctors who publish blogs. Apparently, according to the article, blogs published by doctors are on the rise and many people have concerns with this development. Physicians have been discussing patient information for years in journal articles, papers and books, so what is it that makes this story sensational and important to report? Is it the larger population and wider access Internet readership enjoys over published content? The fact that self-published blog articles are published faster than print material and not subject to any oversight (beyond that the law provides, of course)? Or is it just the Internet makes any story sexy and timely? Personally, I feel the issue is about the answer to this question - is it a doctor who blogs, or a blogger who happens to practice medicine? In other words, do we hold doctors (and perhaps other professionals, such as attorneys, who deal with confidential patient information) to a higher standard than anyone else who blogs?

Patient privacy seems to top the list of concerns, and the NPR article presents both sides of the debate. One the one hand, Dr. Deborah Peel, a psychiatrist and founder of the group Patient Privacy Rights, thinks these blogs may skirt close to invading patients’ privacy rights:

“The problem with physicians blogging about patients is the danger that that person will be able to identify themselves, or that others that know them will be able to identify them,” she says.

Peel’s group worries that information about a patient’s case could be traced back to the individual and adversely affect his or her employment, health insurance or other aspects of his or her life.

“If you [are a doctor and] are unhappy with the people that you’re supposed to be serving and taking care of, you probably need therapy,” she says. “You don’t need to be venting your frustrations in a public manner like that. That’s very inappropriate and unprofessional.”

On the other hand, Dr. Robert Wachter, author of a blog called “Wachter’s World,” disagrees:

“You might say we as doctors should never be talking about experiences with our patients online or in books or in articles.”

Wachter says taken for what they are — unedited opinions, and in some cases entertainment — blogs can give readers some useful insight into the good, the bad and the ugly of the medical profession.

This seems to be a movement that is growing, despite how you feel about possibly being the semi-anonymous subject of your doctor’s blog. The NPR article points to several particular blogs published by doctors, including KevinMD, which in turn links to many more. And privacy concerns will only get worse as “gated communities” like iMedExchange, who claim to verify all community members are themselves doctors, become more popular - the assumption will be, if all the readers are doctors, why even bother sanitizing the identifying information?

How about you - do you care if your doctor is blogging about you? Let us know how you feel in the comments and poll.

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I’ve been lax lately on posting articles (many are in various stages of being published) - a few life-changing events are happening, and I’ve been working on a couple of other projects. I have decided to prematurely launch one project today, due to an interesting survey on Wordpress security released today. The project is a new site called NoShrinkWrap, and will focus on reviewing mainly Web2.0 apps.

I’ve been an avid Techcrunch reader for some time now; while I appreciate the timely and interesting news they post, I’m always left wanting more information on the products they talk about. That is the hole NoShrinkWrap will fill - posting reviews complete with screenshots, company information, tips and tricks, and more. For anyone who doesn’t get web2.0, or who doesn’t understand what an application will do for his or her life, or wants more information on the latest web2.0 buzz app, this site is for you. As I’ve really enjoyed learning more about Wordpress, NoShrinkWrap will also host related topics including plugins, themes and how to write them.

I realized when I started reviewing Joost and Traineo that I really enjoy using and reviewing different apps. I don’t want to saddle TheLifeLedger with unrelated content, and I don’t want to constantly shoe-horn reviewing apps into a health-related topic, so these reviews will move to NoShrinkWrap.

Thanks for being a member of TheLifeLedger community. Expect more articles soon, and I hope you enjoy the new project.

Thanks to Stumbleupon (wikipedia entry), I’m discovering a slew of useful sites hidden in the “invisible web”, which comprises an estimated 90% of all Internet sites. Here’s the latest interesting sites I’ve discovered:

How to Lose 20 lbs. of Fat in 30 Days… Without Doing Any Exercise (stumble reviews) - while I typically ignore “lose weight fast” type articles, this one by Tim Ferriss was worth reading. I wrote a response, modifying Tim’s rules to be more compatible with lifestyle change.

CalorieConnect (stumble reviews) - nice AJAX-powered calorie lookup for common foods. The list doesn’t seem to contain many restaurant-specific items, but it’s a fast and easy resource for quick food lookups. It appears there might also be a nutrition and exercise journal service - if so, I’ll add it to the list of services I’m reviewing.

The Training Station (stumble reviews) - list of 100+ animated pictures demonstrating different exercises, grouped by muscle group.

The Full FATFREE Recipe Collection (stumble reviews) - huge list of recipes, nutrition information and more.

BrainReady’s Top 5 Brain Health Foods (stumble reviews) - Interesting article; also available at the site - daily puzzle worksheets, podcast and more.

CalorieLab (stumble reviews) - HUGE listing of nutrition information, including restaurant items. Site also has RSS feed for health news, calories burned calculator and more. Great find!

What happens if you drink a can of Coke right now? (stumble reviews) - chronicles how your body reacts to a Coke during the first hour after consumption. Fascinating article, I’d love to find more like it.

Mark’s Daily Apple (stumble reviews) - health blog with interesting, unique articles.

You never know what kind of health and fitness stuff you’re going to stumble across. I’m reviewing every site that inspires me enough to “like” or “dislike” it - you can follow my reviews and join up as a friend at http://charshman.stumbleupon.com/. Stumbling yourself? I’d be interested to see the interesting things you’re finding - leave ‘em in the comments, along with your stumbleupon ID so I can join your friends list.