Online Access vs. Office Visits

The British are currently debating the move to online visits with doctors using Skype. According to The Independent, "The Government hopes cutting down on unnecessary face-to-face appointments will free up staff and help fill a £20bn funding gap."

However, NPR reported a new study showed that giving online access to patients actually resulted in more office visits, not less. The study in JAMA concluded: "Overall, our findings suggest that the relationship between online access and utilization is more complex than the simple substitution of online for in-person care suggested by earlier studies."

Indeed, online interactions should not take the place of face-to-face physician encounters, but should be part of the end-to-end patient experience. It is quick and easy to address questions and perform follow-up check-ins in an online environment, rather than making a patient return for another visit.

As an example, FierceHealthIT reports that a health team working through an online disease management program helped Type 2 diabetes patients achieve better A1C results at six months (although the gains were not sustained at 12 months).

For those who worry about the computer coming between doctor and patient, John Halamka recently blogged, "The literature studying outpatient offices with computers in the exam room suggest computers do not get in the way as long as clinicians are facile with them and maintain eye contact with patients."

The relationship between doctors, technology and patients is currently going through its "beta" stage. The more comfortable everyone becomes with these new dynamics, the better we will get at using it to the advantage of all. Join our LinkedIn group: Improving the ePatient Experience to share your ideas and learning.


I disagree. When I am in my doctors office I want his/her full attention and 100 percent eye contact. No notes being typed on their iPad. To reference patient history while the patient is present is acceptable but patient evaluation means the doctor is present in total. Forms are their responsibility after the patient exits the office.

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