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The Perfect Option for Healthcare Interoperability

Posted on December 15, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I’ve come up with the perfect option to take care of healthcare interoperability. I realize that this is a major problem and solving that problem would improve care, lower costs, and make healthcare great again (sorry, I couldn’t help it).

This approach is unique because every healthcare organization out there already supports it. In fact, I don’t know any healthcare organization that would need to spend more money to implement this solution. In fact, the standard this option would use is already out there and everyone has already adopted the standard.

Furthermore, every provider and hospital already have a unique credential and their identity is shared with most of the people that need to share information with them in healthcare. In most cases the information to make the health data sharing between offices and hospitals is already on their website. Plus, this option is something that is easily learned by everyone involved. Most people in healthcare already know how to use it well.

The healthcare interoperability solution I’m describing is: The Fax.

Yeah. It’s shocking I know. That long list of benefits that I describe already exist in the fax. In fact, healthcare data sharing has been happening with faxes for a long time. Why then isn’t fax enough to make healthcare interoperability a reality?

While Fax has plenty of upside (there’s a reason it’s stuck around so long in healthcare), faxes also have a lot of downsides. First is that faxes still have to be sorted and assigned to a patient. This doesn’t happen automatically. It’s still a manual process. Second, faxes are often low quality and readability can really be a problem. Certainly, they’ve gotten better as we’ve started faxing printed reports, but faxes can still be very hard to read.

If you’ve ever worked in medical records, you know how hard it can be to make sure you’re attaching a fax to the right patient. It can be a real challenge. Plus, it’s not surprising that faxes often get attached to the wrong patient.

Another problem with faxes is that they can use up a lot of paper. There are definitely fax servers and other forms of secure electronic fax out there, but it’s shocking how many practices still print regular faxes and then scan and attach them into their EMR. Plus, is the fax really that secure? They can be, but in many cases they’re not. No one is tracking who looks at the faxes that are received. There aren’t restricted permissions on who can and can’t look at the faxes. It’s just an open stack of faxes that anyone can look at and read.

Another big problem with faxes is that they don’t provide any granular data. This is why it’s often hard to identify the correct patient for the fax. However, it’s also a problem as we start wanting to do more predictive analytics and population health efforts that require granular health data on a patient. Sure, you could use OCR (Optical Character Recognition) and NLP (Natural Language Processing) to pull out the details from these unstructured faxes, but that’s not as good as granular data that’s more precise.

Of course, we all love the way the fax produces a Blarrrrrring NOISE!!

While this post is somewhat tongue in cheek, I think it’s important to look back at these “legacy” technologies that have been so popular. Understanding why they have been so popular and in many ways still are so popular can help us understand what the solutions of the future need as a baseline to be a successful replacement. Healthcare Interoperability efforts can certainly learn a lot from the success of faxes in healthcare.

#HITsm Origin Story

Posted on December 14, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

For those who aren’t familiar with the #HITsm hashtag on Twitter, it’s an extraordinary community of people that are passionate about healthcare IT. At the center of the #HITsm community is the weekly #HITsm Twitter chat which has happened every Friday for the past 6 years at Noon ET (9 AM PT). During the week, the #HITsm chat is still extremely active as those in the community share ideas, concepts, and have discussions about healthcare IT.

I did a quick report on Symplur for the #HITsm hashtag and it’s had over 4000 participants sharing 21,577 tweets and generating 154,799,908 impressions in just the last 3 months. Needless to say, it’s a vibrant and passionate community that’s focused on the challenges, problems, and opportunities in healthcare IT. It’s also been an extraordinary way to connect with other people passionate about the impact of technology on healthcare.

Over the past 6 years, Corepoint Health on their Health Standards blog (Use to be known as the HL7 Standards) has been the host of the #HITsm chat and community. However, starting this month, Healthcare Scene has taken over responsibility as host for the #HITsm chat. It’s an extraordinary opportunity and a challenging responsibility to continue the legacy of such an important community.

What many people that are newer to the #HITsm community probably don’t realize is that the #HITsm chat was the genius of Erica Johansen (Better known as @thegr8chalupa). While working at Corepoint Health, she had the great idea to create this healthcare IT community on Twitter. About 6 months later, Chad Johnson (@ochotex) took over the reigns and ran the #HITsm chat with help from a number of other people.

It’s too bad that so many new #HITsm members weren’t familiar with Erica and the great work she did cultivating the initial community. She brought a special energy to the community which is typified by the hashtag on her Twitter profile #alwaysbesparkly. I knew when we took over the #HITsm chat that I had to find a way to bring a little bit of Erica’s sparkle back to the community.

With that in mind, this week Erica will be hosting our weekly #HITsm chat on the topic of reputation management. Plus, she’ll be working with us to coordinate and facilitate hosts and topics as part of our team of #HITsm curators.

Healthcare Scene was also lucky enough to spend some time with Erica when she was attending a conference in Las Vegas. We capitalized on this opportunity by doing a video with Erica about the origins of #HITsm and where she’d like to see the #HITsm community go in the future. If you’ve enjoyed the #HITsm community or are new to #HITsm, you’ll enjoy this video interview with Erica:

Thank you Erica for creating this wonderful community and sharing the #HITsm story. We look forward to working with you to grow the #HITsm community going forward!

If you want to learn more, join the #HITsm Twitter chat every Friday.

Health IT End of Year Loose Ends

Posted on December 13, 2016 I Written By

When Carl Bergman isn't rooting for the Washington Nationals or searching for a Steeler bar, he’s Managing Partner of EHRSelector.com.For the last dozen years, he’s concentrated on EHR consulting and writing. He spent the 80s and 90s as an itinerant project manager doing his small part for the dot com bubble. Prior to that, Bergman served a ten year stretch in the District of Columbia government as a policy and fiscal analyst, a role he recently repeated for a Council member.

In that random scrap heap I refer to as my memory, I’ve compiled several items not worthy of a full post, but that keep nagging me for a mention. Here are the ones that’ve surfaced:

Patient Matching. Ideally, your doc should be able to pull your records from another system like pulling cash from an ATM. The hang up is doing patient matching, which is record sharing’s last mile problem. Patients don’t have a unique identifier, which means to make sure your records are really yours your doctor’s practice has to use several cumbersome workarounds.

The 21st Century Cures Act calls for GAO to study ONC’s approach to patient matching and determine if there’s a need for a standard set of data elements, etc. With luck, GAO will cut to the chase and address the need for a national patient ID.

fEMR. In 2014, I noted Team fEMR, which developed an open source EHR for medical teams working on short term – often crises — projects. I’m pleased to report the project and its leaders Sarah Diane Draugelis and Kevin Zurek are going strong and recently got a grant from the Pollination Project. Bravo.

What’s What. I live in DC, read the Washington Post daily etc., but if I want to know what’s up with HIT in Congress, etc., my first source is Politico’s Morning EHealth. Recommended.

Practice Fusion. Five years ago, I wrote a post that was my note to PF about why I couldn’t be one of their consultants anymore. Since then the post has garnered almost 30,000 hits and just keeps going. As pleased as I am at its longevity, I think it’s only fair to say that it’s pretty long in the tooth, so read it with that in mind.

Ancestry Health. A year ago September, I wrote about Ancestry.com’s beta site Ancestry Health. It lets families document your parents, grandparents, etc., and your medical histories, which can be quite helpful. It also promised to use your family’s depersonalized data for medical research. As an example, I set up King Agamemnon family’s tree. The site is still in beta, which I assume means it’s not going anywhere. Too bad. It’s a thoughtful and useful idea. I also do enjoy getting their occasional “Dear Agamemnon” emails.

Jibo. I’d love to see an AI personal assistant for PCPs, etc., to bring up related information during exams, capture new data, make appointments and prepare scripts. One AI solution that looked promising was Jibo. The bad news is that it keeps missing its beta ship date. However, investors are closing in on $100 million. Stay tuned.

 

MIPS Timeline and Eligibility – MACRA Monday

Posted on December 12, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

This post is part of the MACRA Monday series of blog posts where we dive into the details of the MACRA Quality Payment Program.

In the MACRA final rule, the timeline for MIPS was largely the same. However, I think there was some confusion on the MIPS timeline. So, while this isn’t a change from the MACRA proposed rule, I thought it would be worth highlighting the MIPS timeline for those that will be participating in the MIPS part of MACRA.

This graphic is the most succinct illustration of the MIPS timeline I’ve seen:
mips-timeline

As a summary, data for MIPS will be collected during 2017. How much data needs to be collected depends on which “Pick Your Pace” option you choose (more details on this in a future post). You must submit your MIPS data by March 31st following the performance year. Then, the positive or negative payment adjustment will happen the year after. For example, the 2017 MIPS performance year will determine your Medicare adjustment that goes into effect in 2019.

There was a slight change in who is eligible for MIPS in the MACRA final rule that is going to have a big impact. First, let’s take a look at who is eligible for the MIPS program:
mips-elibility

As you’ll see, there isn’t really a change in which types of providers are eligible for MIPS. However, you do have to have $30,000 in Medicare Part B billing and 100 Medicare patients a year in order to be able to participate in MIPS. Currently this is done on a per provider basis. They’re still considering virtual groups in future years.

There are 3 exceptions for providers that aren’t eligible to participate in MIPS. The newly enrolled doctors and Advanced APMs participants is the same as it was in the final rule. However, the low-volume threshold exception now excludes you from participating in MIPS if you have less than $30,000 in Medicare Part B or see 100 or fewer Medicare Part B patients. That’s a change from the proposed rule.

Here’s the full outline of the 3 MIPS exemptions:
mips-exclusions

That’s a quick look at the MIPS Timeline and Eligibility from the MACRA final rule. Next week we’ll dive into the details for Pick Your Pace. That should help you make a determination for how your practice should approach MIPS in 2017.

Be sure to check out all of our MACRA Monday blog posts where we dive into the details of the MACRA Quality Payment Program.

American Well Deal Adds Remote Physical Exams To Its Offerings

Posted on December 9, 2016 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Telehealth provider American Well has partnered with a vendor allowing patients to conduct and transfer data from their own basic physical exam during telemedical consults.

The partner, TytoCare, offers an “examination platform” allowing patients to do their own medical examination of the heart, lungs, abdomen, ears, throat, skin and temperature at home, then share the information with the clinician before or during their virtual visit.

Tyto’s consumer platform TytoHome, which is priced at $299, combines a digital stethoscope, otoscope, thermometer and examination camera. The company also offers a model, TytoPro, designed for professional use, which offers extended battery life, a headset for listening to heart and lung sounds, initial set of disposables for the otoscope and tongue depressor, and software designed specifically for clinician use. The company doesn’t say what the Pro technology costs.

Tyto’s software platform, meanwhile, offers cloud-based secure digital exchange of clinical data and a clinical repository. The company says it can integrate with most EHR systems as part of its TytoLink integration services. It doesn’t say what those integration services will cost, but it seems likely that they don’t come free.

At least at the outset, the partners plan to deliver services to health systems and employers, but without a doubt plans to scale beyond this. And they’re likely to have the resources to do so. American Well has established a foothold in telemedicine, while Tyto Care has received over $19 million in funding to date from investors that include Walgreens.

It’s worth noting at this point that TytoCare is far from the only player in the market offering remote examination tools. For example, I’m familiar with at least one vendor, MedWand Digital Health, offering a similar bundle of remote examination technologies. The MedWand platform lets consumers measure their heart rate or pulse or pulse ox level, listen to their heart, lungs or abdomen, look into their mouth, throat and ears, examine their skin and take the temperature. It can also integrate with other remote monitoring tools, such as connected glucometers of blood pressure monitors. It sells for $249.

And MedWand, like TytoCare, has venture backing, in this case from a technical partner. The company recently received a “major” investment from the venture arm for Maxim Integrated Products, which designs, manufactures and sells semiconductor products.

In my opinion, however, American Well may have a meaningful advantage over other competitors, as it appears to have fairly strong connections with health plans and health systems. The telehealth vendor has partnerships with more than 170 health plans and systems, and has created an enterprise telehealth platform designed to connect with providers’ clinical information systems.

While a company like MedWand may be better position to scale up a consumer technology offering — given backing by a semiconductor maker — over the near term I’d argue that better to be on good terms with those delivering and financing care. Right now, my guess is that very few consumers are willing to sink almost $300 into a home telehealth platform, even if they occasionally use telemedicine services, but this seems little doubt that health systems and health plans see the value of offering such services in a sophisticated way.

If I were either of these companies — or one of their competitors — I’d try to employers, health plans and health systems to buy and place the devices in the homes of chronically ill or high risk patients. But I don’t know if that’s in their plans. Let’s see how the next 12 months go.

Are Healthcare Orgs Dumping Today’s Interoperability Tech?

Posted on December 8, 2016 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Recently, I took a survey on interoperability issues sponsored by a health IT organization. And one of their questions seemed so interesting — to me at least — that I thought I’d share it with you.

As part of the survey, the HIT group asked how healthcare organizations planned to split their future investments in interoperability, on a scale ranging from 20% technology/80% services to 100% technology. (In the “services” category, they were looking for investments which would transform core technologies to achieve higher value interoperability goals, such as improved clinical workflow integration or significant practice outcomes.)

As I see it, this was not only a good but a provocative question as well. On the surface, I admit, it sounds like a routine query, which attempts to get a feel for what resources healthcare groups may already have invested in interoperability and how they plan to support those investments. Looked at that way, it was a fairly routine inquiry as such surveys go.

But I believe that there’s another way to look at this question, and I bet the authors did too. To my mind, the question is really evaluating whether respondents think current interoperability technology will ever meet their needs, and how far along they are in making that decision. In other words, answering this question says a lot about the strategy and vision for the future, not just how you plan to keep the infrastructure running.

How does this work? To choose one obvious example, organizations that expect to spend 100% of their future interoperability budget on new technology obviously aren’t fans of the technologies available today. That suggests, to me, that they’ve also lost patience to a greater or lesser degree with other current interoperability approaches like FHIR or the use of HIE technology. They probably doubt their current EHR vendor will ever play ball either.

Meanwhile, organizations that expect to spend 80% of the future interoperability budget on related services may be making the opposite statement. Either they are satisfied that the technology they’ve got is at least performing adequately, can be enhanced to perform adequately or can be repurposed if the right services are put in place. The difference between the two may be as simple as whether they’re in a strong partnership with the right vendor, or a difference in philosophy, but either way this group is hunkered down.

As for those in the middle, who expect to vote 40% to 80% of their budget to new technology, it’s harder to read where they’re headed. But assuming the health IT organization repeats the survey in future years, it will be interesting to how the organizations in the middle progress. My guess is that over the next few years, surveys like these will tell us pretty definitively whether current approaches to interoperability can survive.

Advice On Winning Attention For Digital Health Solutions

Posted on December 7, 2016 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Some of you reading this are probably involved with a digital health startup to one degree or another. If so, you’ve probably seen firsthand how difficult it can be to get attention for your solution, no matter how sophisticated it is or how qualified its creators are. In fact, given the fevered pace of digital health’s evolution, you may be facing worse than typical Silicon Valley odds.

That being said, there are strategies for standing out even in this exploding market, according to participants at a recent event dedicated to getting beyond health tech hype. The event, which was written up by health tech startup incubator Rock Health, featured experts from Dignity Health, Humana, Kaiser Permanente and Evidation Health.

Generally speaking, the panelists from these organizations spelled out how health tech startups can make more convincing pitches, largely by providing more robust forms of evidence:

  • They said that standard metrics demonstrating the effectiveness of your solutions — such as randomized trials and evidence-based reviews — probably weren’t enough, as they sometimes don’t translate to real-world results. Instead, what they’d like to see is the product “used under some stress or duress and how it’s received by caregivers, members, patients and their families,” said Dr. Scott Young, who serves as executive director and senior medical director of Kaiser Permanente’s Care Management Institute.
  • They want you to produce “softer feedback” such as stories and testimonials directly from customers and users. “So many solutions claim to do the same thing,” said Karen Lee, innovation and strategic partnerships leader at Humana. “This softer feedback allows us to really get a feel for that experience and whether or not it’s effective.”
  • They expect you to be able to nail down how your product meets their strategic objectives, and can help them achieve the specific outcomes they have in mind. If you can’t do that, though just reach out to someone who can.
  • They want to bear in mind that even if they’re quite interested in what you’re doing, there’s typically a lot of politics to navigate before they can the pilot with your technology, much less implement fully. “Beyond the evidence, a successful pilot, and research, there are some complexities that you have to be patient and working through,” says Lee.
  • Perhaps most importantly, they need to know that you’ve kept the patient in mind. “The patient needs to know how to use [your technology], and should be using it,” said Dr. Manoja Lecamwasam, executive director of intellectual property and strategic innovations at Dignity Health. “You have to first build that foundation – look at it there, and a lot of people want to talk to you.”

At this point, readers, I realize some of you are probably feeling frustrated, as it may seem that many potential digital health adopters have set the bar for adoption very high, even once you’ve proven that your solution works by most conventional methods. Still, it doesn’t hurt to get an idea of how the “other side” thinks.

A Look At An Interoperability Option For Lab Tests and Services

Posted on December 6, 2016 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Maybe I don’t go to the right parties, but I hadn’t heard that HL7 had released an implementation guide offering a standardized way for providers and other health organizations to exchange catalogs of lab tests and services. But I just learned the basics from a recent article on ONC’s HealthIT Buzz blog, and thought you might find them interesting.

The article, which was authored by execs with the American Clinical Laboratory Association, says the new guide can help labs share data electronically in a way that wasn’t possible before. Right now, the article notes, most clinical practice managers in the US must manually curate lab test catalogs. While the article doesn’t specify, it’s hard to imagine how this could fail to be a very time-consuming process.

However, under the new model, things are much different. The HL7 invitation guide describes how labs can provide electronic Directory of Services (eDOS) information to all providers ordering lab work, regardless of whether they are using EHRs, laboratory information systems or other platforms. Also, the guide explains how these labs can enable lab-to-EHR interoperability by using data formats that EHRs can incorporate into lab ordering systems.

The release of the eDOS guide follows a long-term effort by the American Clinical Laboratory Association to standardize lab catalogs for most commonly-ordered tests. The article authors, Steven Posnack and Thomas Sparkman of the ACLA, contend that by using the guide to automate eDOS, practices can reduce labor costs, improve test ordering accuracy through clinical decision support and even phase in precision medicine more rapidly as labs add new services. What’s more, using eDOS, EHRs would be able to import lab test companion information directly, in minutes, which is not possible in most current configurations.

And hear them tell it, the benefits to providers will be tangible. They note that according to ACLA estimates, a typical practice ordering an average of 1,000 frequently-ordered lab tests could potentially save $94,500 solely by using eDOS.

The article also suggests that eDOS implementations are good for labs and health IT developers. They point out that in most cases, specs for laboratory interfaces are customized one offs and nonstandard, but that under eDOS, the specs standardize laboratory data exchange from end to end.

As a non-developer, I can’t comment on how effective this framework is, though the argument made by the ACLA seems promising from a business standpoint. Still, speaking as an observer of this industry for quite some time, I still wish I was hearing about broader solutions that might actually work, rather than solving the problems within one of healthcare’s many silos.

That being said, if it’s actually possible to dramatically boost the efficiency of lab data sharing, the industry should have at it. We can’t let the ideal be the enemy of the better, I suppose.

Advanced APM Timeline – MACRA Monday

Posted on December 5, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

This post is part of the MACRA Monday series of blog posts where we dive into the details of the MACRA Quality Payment Program.

Last week we posted about the APM Expansion in MACRA and the new PTAC Committee. Today we’ll dive into the timelines for APMs. They can get pretty confusing, so hopefully after you read this post you’ll have a better idea on how the APM timelines work.

Before we dive into the timelines, I also wanted to make a quick note of the benefits related to participating in an APM. The APM benefits really didn’t change in the MACRA final rule so our previous post on Advanced APM incentives is still accurate as well.

As we noted before, participating as an advanced APM provides incentives on top of whatever rewards are part of your original APM agreement. Under MACRA, you just get an extra 5% bonus on top of your pre-MACRA rewards for being in an APM. Here are the 3 main benefits of participating as an advanced APM under MACRA:
advanced-apm-benefits

As far as reporting as an Advanced APM, CMS will take three “snapshots” on March 31, June 30, and August 31 in order to determine which eligible providers are eligible as an Advanced APM and meet the thresholds to become a Qualified APM participant.

Here’s the official timeline details from CMS:

cms-apm-determination-timeline

At point B, the snapshots are taken to determine eligibility and at point D in the graph above, eligible providers will be notified of their APM eligibility. Yes, this is a very compressed timeline, so it behooves you to get started early. Remember that if you don’t qualify as an Advanced APM, then you still have to participate in MIPS.

The timeline for paying the 5% reward for being part of a qualified Advanced APM is still 2019 for reporting year 2017. 2018 reporting year will determine payouts for 2020 and so forth. That’s no change from the proposed MACRA rule.

Be sure to check out all of our MACRA Monday blog posts where we dive into the details of the MACRA Quality Payment Program.

E-Patient Update: Patient-Doctor Communication Still Needs an Update

Posted on December 2, 2016 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

A few weeks ago, I called my PCP’s after-hours line to address an urgent medical concern. The staff at the answering service took my name, reached out to the doctor on call and when he was ready, connected him to me.

While this procedure was entirely standard, as always I found it a bit offputting, as to me it implies that I can’t be trusted to use the doctor’s cell phone number with some discretion. Don’t get me wrong, part of me understands why the doctors in this practice preferred to preserve their privacy and select when they want to speak to patients. On the other hand, however, it makes me uneasy, as I already have a very superficial relationship with my PCP and this approach doesn’t help.

While this is very much an old-school problem, to me it points to a larger one which has largely gone unnoticed as we plunge forward with the evolution of health IT. In theory, we are living in a far more connected world, one which puts not only family and friends but the professionals we work with on far more of a one-to-one basis with us. In practice, however, I continue to feel that patient-doctor communication has benefited from this far less than one might think.

I know, you’re going to point out to me how many doctors are using portals to email with patients these days, and how some even text back and forth with us. I’ve certainly been lucky enough to benefit from the consideration of providers who have reached out via these channels to solve urgent problems. And I know some health organizations — such as Kaiser Permanente — have promoted a culture in which doctors and patients communicate frequently via its portal.

The thing is, I think Kaiser’s experience is the exception that proves the rule. Yes, my doctors have indeed communicated with me directly via portals or cell. But the email and text messages I’ve gotten from them are typically brief, almost pointillistic, or if longer and more detailed, typically written days or even weeks after the original request on my end. In other words, these communications aren’t a big improvement over what they could accomplish with an old-fashioned phone call – other than being asynchronous communication that doesn’t require we hook up in real-time.

In saying this, I’m not faulting the clinicians themselves. Nobody can communicate with everyone all the time, particularly doctors with a large caseload. And I’m certainly not suggesting that I expect them to be Facebook buddies with me and chat about the weather. But it is worth looking at the way in which these communication technologies have seemingly failed to enrich the communication between patient and doctor in many cases.

Until we develop a communication channel for patients and doctors which offers more of the benefits of real-time communication — while helping doctors manage their time as they see fit — I think much of the potential of physician-patient communication by Internet will be wasted. I’m not sure what the solution is, but I do hope we find one.