Just a couple of weeks ago, I wrote about doctors who FaceTime or video Skype with their patients. I’ll freely admit that while I’m as addicted to my Smartphone as the next person, I generally feel as if these healthcare innovations will result in overworked doctors and demanding patients.

And now, here’s something else to think about. According to a recent article in Computerworld, pharmacy chain Rite Aid, in conjunction with healthcare provider OptumHealth, is rolling out online physician chat rooms. Patients can virtually chat face-to-face for 10 minutes with a physician for $45. Virtual chats with OptumHealth nurses are free.

Pros of this system:
- Shorter Wait Times: No more Waiting Area blues, and no more wondering if the paper robes cover you adequately enough.
- Doctor-Pharmacy Cross Referencing: If Rite Aid already has a patient’s pharmacy history, the provider/nurse can access it any time. No need to rely on a patient’s memory any more.
- Electronic Capture of Medical Records: These can be communicated to the patient’s PCP in needed.
- No more scheduling tag: Walk in for a chat when YOU are ready.

Cons:
- Steep price: $45 for a 10 minute chat is a tad high in my book. But when you look at it in terms of what the uninsured have to do to get any medical attention at all (either pay the high consultation rates, or negotiate with a kind-hearted doc for lower fees, or wait till their conditions become full-blown emergencies), it doesn’t look as pricey. I would also be really interested in seeing how insurance companies will react to telehealth initiatives like these. Will they, for example, reduce co-pays for such visits?
- Revolving cast of physicians: The advantage of this system is you get to see a medical professional; you’ll probably not be able to ask to be connected to that incredibly insightful Dr. Smith you saw last time. Also if this takes off in a big way, maybe it’ll be a Dr. Reddy located in Hyderabad, India (though I should go on record at this point – I have absolutely no problem in being seen virtually by a Dr. Reddy or Dr. Khan in Pakistan, or anywhere else in the world)
- Unclear logistics: Say, you have an abcess that you have to get checked on your er… backside. Are the kiosks private enough for truly comfortable patient-doctor interaction? Is there anyone else just offscreen at the doctor’s office, watching the video chat?

Definitely things to think about. I want to leave you with anecdotes from a different field – education. A few years ago, tutoring companies in the US figured out that American kids could really benefit from one-on-one tutoring from teachers. VOIP technology became cheap, even international video calls via Skype were free or for pennies a minute. I heard about this phenomenon when I enquired about a teacher at my high school in India. Many teachers at my school had quit to join such companies, and the school was making do with either substandard teachers or filling teaching gaps with part-timers on an ad-hoc basis.

It’s too soon to know what route these TeleHealth initiatives will take, but the scenario I described is not impossible with medicine too. While I’m excited about the convenience of these kiosks, I also think it would be a sad day if all/majority of our interaction with our providers is done online.

In the vast amount of information that comes through my email, Twitter account, RSS feeds, etc one of them recently caught my eye. It was a webinar called, “Insane Ideas in Healthcare IT” by Christine D. Chang; Ovum, Analyst of Healthcare Technology (you can find the archived webinar here if you click around a bit). Here’s the description for the presentation:

All great ideas sound “insane” at first. This presentation will describe three insane ideas that Ovum believes will transform healthcare in the future including:
• Telehealth is for everyone, not just the elderly.
• Patient self-diagnosis is good and should be promoted.
• Personal health records are not just a passing trend, they are the solution.

I really love the concept of considering “insane ideas.” So, my question is what EMR ideas do you have that most people would consider insane?

On EMR and HIPAA, I wrote about an EMR platform which I think some might classify as an insane idea. Sometimes I wonder if becoming a full time entrepeneur doing mostly EMR blogging is an insane idea;-) I think that many might consider the Free EMR software an insane idea.

I had one EMR vendor recently ask me to write about them. He hoped that people’s response to my post would be that they all think it’s crazy to try and build an EMR company that way. I guess he prescribes to the best ideas sounding “insane” at first.

Let’s hear what ideas you think might be insane.