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Wednesday, June 30, 2010

The ambulatory care revolution begins

There is a great article in the NYT today:

Getting Treated for Common Ailments Online

If a Zipnosis patient is using a smart phone with GPS, they can touch a button and their prescription will be electronically sent to the nearest pharmacy or the pharmacy of their choice.Park Nicollet Health ServicesZipnosis patients using a smartphone with G.P.S. can touch a button and their prescriptions will be electronically sent to the nearest pharmacy or the pharmacy of their choice.
In a recent Bucks post, “Doctors, Let Me Pay You for E-Mail,” my colleague Ron Lieber said he would gladly pay his family doctors a flat annual fee to be able to e-mail them questions and get a timely electronic response, and he questioned why this isn’t the norm.
Well, it turns out that it’s possible now in one state, Minnesota, to pay $25 and then actually get treated for certain basic ailments online thanks to a just-introduced  yearlong pilot program offered by the health care provider Park Nicollet Health Services and, a start-up in Minnesota.

The idea is elegant and simple. Pick a short list of illnesses which affect normally healthy people and make them acutely uncomfortable:
1. Colds
2. UTI
3. Yeast infections ... 
to name but a few.  Have patients fill out a form online to sort out potential high risk situations. Address the concern for modest fee (slightly less than an office visit co-pay) which does not involve insurance.  Everyone is a winner. The patient is spared a visit and the time required at a financially neutral cost. The physician does not have to support a bricks and mortar overhead, has an encounter which is all but completely documented by the patient, and collects the money with basically no transaction costs associated with filing a claim. The insurer doesn't have to pay for the visit. The claim is this is not particularly lucrative. Once the information systems are in place and it is scalable, it can almost be automatic and the overhead approaches zero. 
The requirement for this type of care is two fold. The diagnosis and  treatment must basically be rules based and the stakes must be relatively low. The other feature of this is this will yield a huge amount of data in a format which can be easily queried. Data is power. I predict this will become the norm for addressing common acute problems in essentially well people so fast it will make our heads spin. 

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