Michigan Physicians Blazing an Online Trail

Published May 1, 2009

Efforts by Michigan doctors to boost their online services over the past three years are paying dividends for patients with chronic health conditions.

The advances include services allowing patients to schedule appointments or provide information to physicians via the Internet. They also allow doctors to issue prescriptions, collect data on patients, and share information with specialists, all online.

‘Ahead of the Game’

“We can do our banking online, our book-ordering online, so we felt patients should have the service of being able to request appointments online or prescriptions online,” said Lori Kostoff, a pharmacist and director of the Huron Valley Physicians Association, an Ann Arbor-based organization of more than 750 area physicians. “I think Michigan’s ahead of the game.”

Kostoff said Michigan health care providers have embraced technology because of doctor and employer demand. The process was helped along by an incentive program created by Blue Cross Blue Shield to help providers switch to electronic systems.

“Physicians here in Michigan were more active in driving this and saying, let’s try to do this all together,” Kostoff said. “Before, doctors were subject to several varying clinical guidelines, so they complained and sparked an effort to get different health organizations in Michigan to set a standard.”

Providing Better Customer Service

“The transition to an electronic system could potentially better serve the consumer,” said Jack McHugh, senior legislative analyst for the Michigan-based Mackinac Center.

“Trained health care experts are a scarce resource, and maximizing the utilization of that scarce resource through technology will allow more efficient use of it,” McHugh said. “This is the pattern in every other area of the economy that is not heavily regulated and skewed by government regulations, and it makes as much sense with health care as it would with any other type of service.”

“Telemedicine has the potential to greatly increase access at lower cost while treating the entire patient,” said Michigan State Rep. Bruce Caswell (R-Hillsdale). However, he cautioned, the real development “can only be done in the private sector.”

“Outside of setting goals, as we have done in Michigan, government must step back and let the doctors and hospitals learn what works and what doesn’t,” said Caswell.

Improving Quality of Care

Among Huron Valley’s member physicians, 156 are currently using the electronic system. They have scheduled more than 1,500 appointments through the online interface, Kostoff says.

“The demand is picking up, as we expected,” Kostoff said. “Patients who are using it go to one doctor, where they started using the electronic system, and they go to another doctor, who isn’t using it, and they ask, ‘Why don’t you have this?'”

Saving Time, Money

Diane Sayers, medical director for the Detroit-based Henry Ford Medical Group, which has implemented an electronic system, said “one of the system’s best features is its e-visits.”

“Patients can use the Internet to voice a concern—anything from earaches to allergies to more chronic complaints—and the computer software uses branching logic, asking a series of questions dependent on previous answers, similar to what a doctor would ask if the patient were in an actual office,” said Sayers. “The patient also has an opportunity to type in any additional information they find relevant.

“The computer program then presents the information collected to the doctor in a standard format, and the doctor can respond and treat the patient remotely. Doctors can also virtually transmit prescriptions for patients, and the entire system is secure and private,” Sayers said.

“For the uninsured, an e-visit costs $20, payable by credit card online, which is definitely less expensive than an office visit, plus missing work and paying for gas,” Sayers said.

About 300 Henry Ford primary care doctors are using the system, which has clocked about 3,000 e-visits, according to Sayers. “Those who have had a hard time getting away from work, along with college students, are some of the primary users of e-visits,” she said

“I think it helps us see more people, and we’re on the leading edge of the wave, in a sense. As we get more of our docs [online] we get the word out to our patients more and more,” Sayers said.

Jillian Melchior ([email protected]) writes from Michigan.