Is this "free" technology worth it?

Patients who visit internist/pediatrician Salvatore S. Volpe's office in Staten Island, NY, can complete update and other intake forms the old-fashioned way, with paper and pen. Or they can do it via Volpe's recently acquired PhreesiaPads-wireless electronic devices that are roughly the size of an Etch-A-Sketch, weigh just over 3 pounds, and don't require computer literacy to operate.

The handheld "webpads" prompt patients to type their name on a touch-screen keyboard, then answer a series of multiple-choice questions about their history and presenting problem. When patients finish, a report is automatically sent via e-mail to Volpe's back office, where it's printed out so that he can review it before entering the exam room.

At the same time, a summary of the material input by the patient-including gender, age, and symptoms-is directed to Phreesia's central server, which in turn immediately displays drug-company-sponsored educational material for the patient. It discusses his central complaint and indicates which of the sponsors' products might be appropriate for him.

In bringing direct-to-consumer advertising into doctors' offices, pharmaceutical companies are coupling their pitches with services directed at physicians and their patients. And they're frank about why they're doing it: Patients are more likely to request a drug or device that they learn about at the point of care, plus the ads can be aimed at the people who are most likely to be interested in a particular item.

But do patients find the ads intrusive or instructive? What's in it for physicians? And do these in-office materials represent too-close-for-comfort associations with big pharma?

Influencing patients at the decision point

"PhreesiaPads help physicians gather important, legible information before seeing the patient," says Chaim Indig, CEO of Phreesia, which is located in New York City. "This shortens visits, reduces error rates, and increases office efficiency. Our technology also enables physicians to have comprehensive documentation of intake interviews, so that they can code more accurately. And Phreesia-generated reports can be directly inserted into electronic health records, decreasing data entry costs and saving staff time."

Another advantage, says Indig, is that patients who are given PhreesiaPads can be productive in the waiting room instead of just sitting there and leafing through old magazines. Volpe concurs. "The patient has been prompted to think through the reasons for the visit, and has been given the opportunity to document those reasons. Visits aren't necessarily shorter, but more items get addressed during the same time period."

Patient privacy is protected, Indig continues, because all identifying information-including name, date of birth, and insurance carrier-is stripped from the PhreesiaPad's memory before being directed to Phreesia's server. Phreesia doesn't store any of the information collected from the patient, nor does it share that information with third parties, so no HIPAA rules are broken.

A practice that uses PhreesiaPads needs broadband Internet access, but the company provides everything else, including the hardware and wireless network. Phreesia delivers two or three webpads to physician offices, places the units in the waiting room, and provides technical support.