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Physicians, patients must work together on new electronic relationships

BOSTON The "office visit" of the future will likely involve patient and physician sitting in front of cameras mounted atop computer terminals, the doctor examining a rash or monitoring a symptom diary while the two converse verbally or electronically, two Beth Israel Deaconess Medical Center (BIDMC) primary care physicians write in the New England Journal of Medicine.

This new dynamic will lead patients and health care professionals to work together to ensure a transparent system that enables them to share knowledge, responsibility and decision-making more equally, Tom Delbanco, M.D., and Daniel Z. Sands, M.D., M.P.H. write in the April 22 edition.

"Patients will soon have full and continuous access to all notes in their personal, electronic medical record offering them the opportunity to suggest amendments, to disagree with their doctors' views, and to point out and correct errors," says Delbanco. "This should enhance patient safety and promote both patient responsibility and shared decision-making."

The growth of electronic communication options presents both opportunities and challenges. E-mail and secure web-based portals offer patients better access both to their physician and to applications where they can review their medications and correct errors, request prescription refills, make appointments, retrieve laboratory results and view radiology images. PatientSiteTM, BIDMC's secure portal, can be found at https://patientsite.bidmc.harvard.edu.

But surveys find physicians are less enthusiastic about electronic communication than are their patients, with only about a quarter of practicing physicians reporting they had conducted e-mail conversations with patients and few encourage the practice as a matter of course.

Despite early experiences that suggest e-mail interchanges can offset costs incurred by telephone calls, missed or avoidable appointments, medication errors
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Contact: Jerry Berger
jberger@bidmc.harvard.edu
617-667-7308
Beth Israel Deaconess Medical Center
21-Apr-2004


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