Personal Health Records: Pay us for reading these new PHRs, say internists

A new patient has compiled a voluminous medical history using the new Google PHR, and he wants you to incorporate the data into your records. The AmericanCollege of Physicians believes you should be compensated for that.

With fee-for-service being the economic norm in medicine, physicians are paid almost exclusively for work performed during face-to-face encounters, according to a recent ACP position paper titled E-Health and its Impact on Medical Practice. Although a few insurers pay for online consultations, what a doctor does in the realm of e-health generally goes uncompensated, the paper stated. And that’s an economic hardship.

Dealing with a patient’s PHR is a good example. To be sure, it may contain valuable information that belongs in the medical record maintained by the doctor, but the doctor needs to carefully review the PHR beforehand to spot any erroneous information. Responding to the new data-maybe the doctor should rethink the medications he’s prescribed-is more work. The ACP recommends that third-party payers reimburse doctors for all this 

Payers also should pay physicians for taking the time to analyze print-outs of Internet health information that patients bring with them to the exam room, according to the ACP position paper. Likewise, the ACP supports reimbursement for online communication between doctor and patient.

The ACP notes that digital medicine dovetails with the concept of the “patient-centered medical home,” which the society holds up as a way to provide more accessible, holistic, and coordinated care. In this model, also endorsed by the American Academy of Family Physicians, the American Academy of Pediatrics (AAP) and American Osteopathic Association, insurers would pay doctors for services rendered outside the exam room, such as studying someone’s PHR, as well as for face-to-face visits.