You may have experienced some dilemmas with your health care in the last few years, but whether to friend your doctor on Facebook probably hasn't been one of them.
Still, medicine is ripe for the transformative qualities of web 2.0 - with or without health-care reform on a national level. The web has already been shaking up the relationships that doctors and patients have taken for granted for most of the 20th century. From innovative models for clinics, to patients having their medical records available as part of their Google accounts, to iPhone apps that remind you when to take your pills, technology is giving us more control over our health.
One new model for health care is New York City's Hello Health. Company founders have said they wanted health care to be as easy as ordering a book from Amazon. Hello Health functions like a virtual clinic or a "concierge practice."
"You pay by the hour to visit your doctor - whether it's in their office, or through email, IM or video chat on HelloHealth.com," explains the company's easy-to-navigate, brightly designed website. Actually, simple email advice is often free (after the $35/month it costs to be a Hello Health member).
Members pick doctors from the Hello Health website: "Remember those days of picking a random name off a list of thousands? ...those days are over," says the ordinary-guy voice on the site's welcome video (embedded, and hosted by Vimeo). Doctors write their own profiles, which appear on pages that look not unlike the Facebook interface. Potential patients find out where they studied medicine, but also if they like dogs or cats, and what their favorite books and movies might be. While you might think you don't care about that, it does humanize what's become in so many cases a terribly impersonal relationship.
Members schedule their appointments online and choose between an actual doctor visit and what the site calls "meetups" - an IM or videoconference session with your doc. "Or shoot off an email, no appointment necessary."
Doctors sign up with Hello Health, joining a network of caregivers, using the company's marketing and software, yet returning to something much more akin to the independent practices you'll probably remember if you're over 40. Doctors "set their own prices," receive "simple payments for their services," take advantage of "Internet conveniences," and have more "time to do their job well."
Why strike out on their own? "A Hello Health practice cuts in half the overhead found in a traditional doctor's practice simply because the platform streamlines processes and eliminates the need for receptionists, administration and nursing staff," states the welcome page.
Hello Health also maintains a blog about trends in health care, "Physician, Free Thyself."
The simplicity is appealing. Patients pay a $35 monthly subscription fee and $100 to $200 an hour for online or office visits. Brief email queries are free. If patients have insurance, they can attempt to be reimbursed. A lot of what doctors do when patients feel sick could be dealt with in this way at low cost - with or without insurance. Catastrophic care insurance, however, would still be a good idea.
Doctors are choosing smaller independent practices even without the infrastructure of businesses like Hello Health, taking advantage of other technology to help them go it alone. The movement known as Ideal Medical Practices, for instance, supports some of these physicians; a Google map lists where these practices are located. These doctors, often having been frustrated working with HMOs, strive for more one-on-one time, and take advantage of online scheduling and direct communication via telephone and email. Patient service is also customer service - one doctor offers a $5 gift certificate if an appointment starts more than 15 minutes late. It's a small thing, but it shows that effort's being made.
Patients and health-conscious consumers have more technology available to help them - no further away than their smartphone. There are many iPhone apps to help people keep track of diet and fitness goals. Others, like GlucoseBuddy, help diabetics track sugar intake.
But they're only the early generations of such apps; research is moving to more tightly integrate direct health monitoring and mobile transmission of the info to a health-care professional. Imagine, for instance, a stethoscope that links directly to a mobile phone, for heart monitoring; or a phone with a blood pressure cuff for blood pressure readings. Info is uploaded through the phone and sent directly to a doctor. The iMedicalApps website keeps track of developments and reviews existing medical apps.
Although it hasn't caught on yet, Google Health is already available as a way that consumers can keep all their medical info and records easily accessible and in one place. If you've changed health-care providers and had to go through the clumsy process of requesting that your paper records be transferred from one company to another, this might be reassuring.
Consumers may be able to import their health-care records to Google Health from their provider, or their prescription records from their drugstore.
Google Health also links to various health-care options, including Hello Health, MDLivecare, and drug comparison and prescription savings programs. Some of these programs draw from information already in your Google Health profile to match consumers with services and professionals that fit their specific needs.