The New York Times > Technology > Digital Rx: Take Two Aspirins and E-Mail Me in the Morning

In the Digital Rx: Take Two Aspirins and E-Mail Me in the Morning article, the New York Times describes adoption of email by both doctors and patients to communicate regarding minor health advice about existing problems, questions they may have about medication, etc. In fact, some health care providers encourage such interactions, paying doctors a near equivalent of an office visit. Doctors like it (and I can see why, most of them hate the office visits part of their job).

Use of the Internet for obtaining health information and support has been a topic of interest to research for several years now (although little has been written on this topic outside the support-group type literature). Of course, cutting down on the number of office visits may actually be beneficial because people can reduce potential exposure to negative elements and get sick less in the process. All of this sounds wonderful, but I wonder what provisions does HIPPA have for e-mail communication. I do remember having to sign a form at my doctor's office so that I could email him and request a drug refill. However, how long does this protection last? If a computer gets searched or hacked, what happens to this information? E-mail is very rarely encrypted (a bizzarre human behavior that some have been trying to explain for years), it is the equivalent of a postcard. Would you describe your medical condition on a postcard and send it in the mail? Probably not. So how can email be used in such a way where it will protect medical information while providing the convenience of such communication?

Technology has been implicated in many medicine-related uses in the news recently. Not too long ago Reuters reported on the use of camera-phones for making routine diagnosis of leg sores by Swiss doctors. Of course, such practice would never be accepted in the US (besides the fact that one does not really need to actually see the sores to make the right diagnosis, apparently). However, ability to transfer images and text may be an accepted use of technology for medicine soon (this may put at risk those of us, unfortunate enough to have exotic diseases masquarading as something else of course, but these are the chances we take). In a few years, not only would you be able to find others to ask questions about a particular symptom or disease, get emotional support from strangers, etc. You would also be able to ping your doctor about that refill he owes you, or whether it's time to switch the drug you are taking to something more or less potent. Digital age, here we come. So what happens to populations that do not have access to such technology for one reason or another? I suspect once the payment structure for such services is in place, doctors will put quite a bit of effort into encouraging this practice (they save time and don't actually have to chit-chat with their patients). The question, of course, remains, just how reliable will this system be, and how long until the first lawsuit.