Health

Minneapolis (AP) ― Some of the biggest health care providers, including HealthPartners and Blue Cross and Blue Shield, are now covering e-mail visits between patients and doctors.

It's an unusual step nationally, and part of an attempt to do something about exploding health care costs. Some experts say such e-visits could produce billions of dollars a year in savings, and cut down on time and travel for patients with routine medical issues.

Under the plan, patients pay the same co-pay as they would for an office visit, and doctors get reimbursed about $35 for each patient e-mail they respond to.

"It certainly is very helpful," said Dr. Michael Ainslie, chairman of the Minnesota Medical Association who practices at Park Nicollet Clinic in St. Louis Park. "I don't think it will ever take the place of a one-on-one interview, but I think it will be a useful tool."

Ainslie, a pediatric endocrinologist, has more than 2,000 patients, the majority children with diabetes. Many live in greater Minnesota or abroad, and he responds to a dozen or more e-mail questions every week.

One of Ainslie's patients is the 14-year-old daughter of missionaries in Tanzania. He said the girl's mother e-mails him regularly with updates on her daughter's blood sugar level, diet and activities.

"I think her mom has really appreciated being able to e-mail us back and forth," Ainslie said. "She said she feels isolated out there and is not getting the information she needs from physicians in her own community."

The concept of e-visits may need time to take hold on a wider level. A new report shows that fewer than one in four doctors talk with patients over e-mail -- mainly because they're not getting paid for. Doctors are also worried about becoming overwhelmed with trivial messages, said Joy Grossman, who helped prepare the report for the Center for Studying Health System Change.

Patients are necessarily seizing the opportunity, either. Minnetonka-based Medica has offered e-visits for more than three years to customers of its Patient Choice business, but fewer than 100 out of 75,000 eligible individuals have signed up.

Ann Robinow, vice president and general manager of Patient Choice, said the biggest sticking point is the co-pay.
"Customers say they want this, but they're not used to paying for things on the Internet," she said.

No one believes e-visits will become an alternative for regular doctor visits. Insurers generally cover them only for established doctor-patient relationships, and doctors say they work best in cases where a patient is in long-term case for an ongoing condition, like diabetes, high blood pressure or asthma.

Bloomington-based HealtPartners started covering e-visits this year. About 100 customers used the service between April and August, said Kevin Palattao, vice president of patient care systems. He expects traffic to pick up.

"We're still trying to get people to adopt the Internet as a common online tool for medical care," he said. "Look at banking, the airlines. It took about eight years for those to become mainstream."

Rick Sanderson has a lengthy list of medical issues: heart problems, diabetes, sleep apnea, depression and high cholesterol. The 47-year-old has been communicating with his doctor online for about a year, using HealthPartners' Web-based service, MyChart. He's able to log vital statistics, e-mail his doctor and link to other online resources for information on his conditions.

"It's been very favorable," Sanderson said. "I much prefer going online. If I can do anything online, I do it."
Sanderson said he saves money by making fewer office visits, though he still pays a co-payt each time he talks to his doctor online. He also saves travel time to his three doctors around the Twin Cities.

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