Pediatric Informatics: Computer Applications in Child Health (Health ...

24 Information Management by Patients and Parents in Health and Disease 321
such as American Academy of Pediatrics (AAP) to consider and publish articles on
standards for its use and reimbursement. 4 The AAP has proposed to replace current
insurance codes (current procedural terminology (CPT) ) for telephone care with
a new group of “Non-Face-to-Face Care” codes that include telephone, e-mail,
and online services. These codes are still in development and will require assessments
for appropriate resource-based relative value scales (RBRVS) that will help
determine reimbursements.
24.2.3 Electronic Mail and Secure Messaging:
Asynchronous Communication
Electronic mail (also discussed in Chapter 23) use by physicians with their patients
is currently low (about one in four physicians), although there has been some
increase in the last five years, with rates of increased adoption correlated to practice
size (see Fig. 24.1). 5
Reasons for this trend include non-reimbursement for advice and services
rendered through e-mail and other issues about security, medico-legal liability
50%
40%
30%
20%
10%
0
24#
4
20
ALL
PHYSICIANS
CHANGE FROM 2000-01 TO 2004-05
2000-01
20*# 19*#
SOLO/2
4 4
16* 15*
3 TO 9
10 TO 50
>50 (R)
Fig. 24.1 Patient–physician e-mail use according to practice size 5
23
5
18*
29
27
2
43*
MEDICAL
SCHOOL
4
43* 43*
STAFF/
GROUP HMO
* Difference from reference group (R) within each year is statistically significant at p