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Advanced Monitoring

A multitude of new devices are designed to help improve the management of chronic diseases. For example, patients can take daily blood sugar readings with a home glucose meter linked wirelessly to a cell phone and then send that data to providers via text message. Such innovations promise many benefits for patients--but not all physicians are convinced.

Richard L. Reece, MD
Editor-in-chief, Physician Practice Options
Old Saybrook, CT

I think doctors are highly skeptical about IT relieving the burden on their practice for a couple of reasons. One, with electronic medical records, they don't see any return on investment. Two, it disrupts their practice. And three, it costs too much, especially when you include maintenance of the technology. I think that is one of the principal reasons only 10 percent to 20 percent of doctors in small practices have gone to EMRs, and probably only 20 percent communicate by e-mail. E-mail communication, in their minds, is not part of their normal practice flow, so they have not adapted to that yet. Some health plans do reimburse for time spent e-mailing--it's seen as a way of giving patients more options. It's an evolutionary thing, however, and we are in the early stages.

Vince Kuraitis
Principal
Better Health Technologies, LLC
Boise, ID

The current system is one that is totally designed to provide in-person care--and that is all the system reimburses for. The assumption is that is how care is delivered, and in the old days that was a valid assumption. But now we are changing the assumption that care has to be delivered and/or reimbursed in person. As a result, doctors will be doing more virtual care, and the other part of the equation is they'll also be getting paid for it. It will be a change in their work flow, but I would say it is good because we are changing the thought process on what is the optimal way to deliver care. For a lot of things, you don't have to be in front of the doctor. I think the new technologies will improve patient care, especially because they have the potential to make doctors more competitive.