Pilot project to pay physicians for e-mail "visits"

Technology firms are taking further steps to get physicians more involved in using technology.

By Tyler Chin, amednews staff. April 9, 2001.

In another sign that employers are making it a priority to get doctors to use information technology, six self-insured Silicon Valley companies are promising to pay physicians a fee to cover e-mail contact with patients.

The six companies say they plan to launch a pilot project April 15 in which they will pay doctors $20 per clinical e-mail "visit" involving nonurgent health matters. The employers, calling themselves the Silicon Valley Employers Forum, hope the use of information technology can lower costs and improve care.

The companies are Cisco Systems Inc., Oracle Corp., Adobe Systems Inc., Cadence Design Systems Inc. and NEC Electronics, plus one company that was not identified. About 100 doctors will be involved in the pilot; they are expected to recruit about 2,000 employees to participate.

The pilot is scheduled to last six to eight months, said Giovanni Colella, MD, a psychiatrist and CEO of Healinx Corp., Alameda, Calif., which is providing the technology. It's limited to employees whose health plans are administered by Hartford, Conn.-based Aetna Inc. and UnitedHealthGroup Inc., based in Minnetonka, Minn.

When employees of those companies want to ask doctors questions that are clinical in nature, they access a secure part of Healinx's site and fill out a questionnaire. Healinx's system analyzes the problem, recommends treatment guidelines and forwards the information to the patient's physician to review, Dr. Colella said.

Despite the popularity of e-mail among doctors and patients, they have been slow to connect with each other -- partly due to privacy concerns, as well as to a lack of reimbursement. First Health Group Corp., a PPO administrator based in Downers Grove, Ill., offers cash incentives to doctors who have e-mail consultations with chronically ill patients.

However, insurers for the most part don't reimburse time spent e-mailing patients.

The Silicon Valley Employers Forum certainly is not the first group of employers trying to encourage doctors to incorporate information technology in their practice.

General Motors Corp., one of the nation's largest employers, and Medscape Inc. have finalized plans to launch by July a three-year program to encourage physicians to use electronic prescription and medical records systems.

The plan doesn't cover payments for e-mail contact. But under the initiative, the companies will recruit about 6,000 physicians who treat a large number of GM employees to use Medscape's technology products, hoping that that will help GM, which is self-insured, to lower drug costs by electronically delivering pharmaceutical information to doctors at the point of care.

The company and Medscape will give away, or charge only a small fee for, Palm handheld devices that would include Medscape software. GM also will encourage physicians to use Medscape's Logician electronic medical record software. But Logician, which runs $4,000 per physician per year, won't be given away. GM and Medscape said they will cover half that cost in the first year, with physicians paying the full fee thereafter.

About 5,000 physicians will receive handhelds, while 1,000 physicians, mostly in towns smaller than 100,000 people, will get a pitch for Logician.

This project complements but is separate from another patient-safety initiative in which GM is involved called the Leapfrog Group, a coalition of Fortune 500 companies that has gone on record as saying its members will favor hospitals and physicians who use computerized physician order entry systems.

The Michigan State Medical Society said it supported the handheld initiative because it complements work the society already is doing to encourage physicians to use handhelds to access clinical information and improve patient safety, said Kevin Kelly, MSMS's managing director.

GM said it evaluated nearly 50 companies over a six-month period before picking Medscape. It declined to identify the other companies.