VIP Panel: Barriers to the Internet in Medicine (eCare) and Possible Solutions - Robert Pretlow, MD  - Tuesday, October 17, 2006

Utilization of Internet technology in patient/client care (eCare) has progressed little since MedNet first convened 10 years ago. Intel Corporation has stated, “The healthcare industry is behind even the trucking industry in implementation of information technology [1].” A newly published study reveals that only 2.9% of 4203 physicians surveyed use email frequently with patients, even though consumers desire such, and most other professions use email routinely with clients [2]. Moreover, physicians routinely use email for all professional activities except for communication with patients. Use of more advanced Internet technology in medicine, e.g. patient home monitoring, is also negligible. What are the reasons for such low use of Internet technology for patient care? Reimbursement for eCare in the U.S. and most other countries is almost nil. A few Blue Cross / Blue Shield groups are reimbursing in limited amounts for non-urgent online consultations, but only for specific vendor applications. A survey of 52 Seattle physicians found that 88.4% would use the Internet for patient care, and 75% would use Internet home monitoring, if they were reimbursed [3]. In addition to reimbursement issues, the physicians listed time constraints, data overload, privacy and confidentiality concerns, liability fears, interstate licensure issues, patient Internet access (the "digital divide"), and provider/patient computer knowledge as barriers to eCare.

This special panel will explore the impediments to eCare and what solutions are available.

Confirmed speakers are:

Robert Pretlow, MD, CEO, eHealth International - Chair
Bill Crounse, MD, Healthcare Industry Director, Microsoft Corp.
Mark Blatt MD, MBA, Director of Global Healthcare Strategies, Intel Corp.
John Tooker, MD, CEO, American College of Physicians
Nancy Davenport-Ennis, CEO, National Patient Advocate Foundation
Jonathan Linkous, Executive Director, American Telemedicine Association
Carol M. Stock, JD, MN, RN, Carol M. Stock & Associates, eHealth Legal Services

Invited, but unconfirmed speakers, include:

U.S. Senator Maria Cantwell - will send a representative from the U.S. Congress
Mark McClellan, MD, PhD, Administrator, U.S. Medicare/Medicaid Services
Tom Richards, Senior Vice President Product, CIGNA Healthcare
Larry Leisure, Senior Vice President, Kaiser Permanente

The session will consist of 15 minutes of prepared remarks by each panelist, followed by 30 minutes of open discussion with the audience. 
A list of action items will be compiled to address the current obstacles to utilization of eCare.


1. McGeady, S., Vice President, Director, Intel Internet Health Initiative, Intel Corporation, 1999.

2. Brooks, R, Menachemi, N., Physicians’ Use of Email With Patients: Factors Influencing Electronic Communication and Adherence to Best Practices, Volume 8, Issue 1, Article e2.

3. Stock, C., Provider Use and Views of the Internet in Medical Practice, MedNet 2005.