Should I Worry About the Quality of Healthcare I'm Getting from Telemedicine?

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If I look at who are the E-Health leaders in America today, not the rest of the world but in America, certain groups stand out and almost without exception their business model is manage care. So the Kaisers, Group Ls health the guys who go to the UPMCs who service both payer and provider of care.

And the reason is not that the rest of healthcare in America these other systems don't have great technology they do, but it's the business model that holds them back. Because of course if you are both the payer of care and the provider of care in one organization then I as a clinician in that organization if I can meet your need as a patient with an instant message or an email, or a video visit and it satisfies your need and it actually keeps you from physically having to come into our system where you start consuming stuff and supplies lots of things, everybody wins.

Your problem is taken care of more efficiently, you're happier, I get paid regardless. It's a good thing for everybody. You go to another system where reimbursement is about volume, and people coming in and having things done to them, then the business model falls apart. So one of the things I'm hopeful about is, if you're sort of on the campaign, and you think about health reform and you think that we really will get to value based care rather than volume based care on accountable care organizations and all of that.

And healthcare starts really looking at a different payment model that rewards doctors for keeping you well and keeping you out of the system then it would level the playing field. At all these organizations they have great technology would be able to apply it in new and innovative ways to meet your needs.

So, I'm very hopeful about that. We do indeed need change, and payment methodology, and getting rid of some of the perverse incentives in American medicine that prevent the use of technology that otherwise would be soundly used.