Barriers of health care communication
*REIMBURSEMENT BARRIERS
An important barrier to use of the Internet by providers in patient care has
been the lack of a reimbursement structure. The magic key to reimbursement is to have approval for Medicare payment.
Direct payment (out of pocket) by the consumer is also an approach that is being explored. A Harris survey queried consumers about how much they would pay for the privilege of e-mail correspondence in lieu of an office visit or using the telephone.
Research from pilot programs using web messaging in clinical care has found that both physicians and patients preferred it to the telephone if there were no time-sensitive issues involved .
Telephone volume was found to be lower in primary care practices utilizing web messaging .Other research has found that physicians used a secure web-based portal for administrative functions such as refill requests and appointment scheduling, but were resistant to receiving or sending messages about the clinical care of patients . This was true in spite of the fact that 38% of physicians surveyed communicated with their own personal physicians using e-mail and an additional 19% would like to be able to do so. The primary barrier to use of e-mail in clinical care cited by physicians was, once again, lack of a reimbursement system that would compensate for loss of office visit revenue.
*“DIGITAL DIVIDE” BARRIERS
Another important barrier to the use of electronic communication in patient care is the fact that Internet use and e-mail adoption are not uniform across the entire population; this has been dubbed the “digital divide.” The digital divide is often characterized in age, racial, ethnic, socio-economic, and disability terms. The highest Internet usage rates are found among those who are younger, richer, and have more years of formal education.
Finally, just because someone has access to the Internet does not mean they can read and comprehend the written information. Most websites continue to provide information at levels that would exclude significant numbers of the general population from understanding the information because of low health literacy
Inter-professional Use of Electronic Communication
Electronic means of communication among providers are resulting in startling changes in the delivery of health care. Many providers are using e-mail to better coordinate care of individual patients. Research has shown that pharmacists and physicians who are within the same health care system can facilitate communication by using electronic mail . Unfortunately, use of e-mail among providers related to the care of a patient has the same privacy and system security concerns and risks of HIPAA (Health Insurance Portability and Accountability Act) violations as does use of e-mail between providers and patients. If you send or receive patient information to anyone via your computer, either with computer-generated fax or e-mail, you are required to be HIPAA compliant.