Dr. Randall Wolf

 
Most often when I’m asked about how the Internet is changing the face of medicine, I’m asked about remote surgery being conducted via satellite video, tools that can monitor blood pressure or medicine remotely, or consulting with medical experts in other countries to get a second opinion via live video over the Internet.  While these are all activities that I have personally taken part in as a physician, they are not the ones that will really revolutionize healthcare.  The Internet has made all these medical interventions a possibility, but I believe that the Internet’s real killer app for medicine may in fact be email. The kind of medicine that I’m practicing today is what I like to call The Doctor's Visit of the 21 ^st Century.   It will indeed rely on the Internet to improve patient care, shorten wait times and eliminate unnecessary office by connecting doctors and their patients over the Internet in advance of an actual office visit.
  
I practice medicine in Cincinnati as a specialist surgeon. Throughout my career I have consulted with patients around the country, and around the world. I’m currently teaching at the University of Cincinnati and Capital University in Beijing, and I’m sharing my view globally about this new way of practicing medicine.  Reviewing patient files, symptoms and test results, prior to an office visit, is one of the most promising advances going on in medicine right now.   And its one of the most beneficial ways physicians can use the Internet, from a medical point of view, to improve patient care.  I can personally attest to the fact that it has helped me eliminate unnecessary visits and makes my office time with my patients more productive.
 
While many doctors have begun emailing with their patients who have more chronic conditions, using the Internet to actually evaluate patients hasn’t been broadly adopted yet.  However, the concept is simple, and adoption requires little equipment or training.  Here’s how it works. Typically, when you go to see the doctor, the first thing you do in the waiting room is fill out a health history form which must be reviewed by the doctor at the beginning of your visit – which is already a very limited amount of time.  After a review of the information and your symptoms, the physician may order blood work, an X-ray, a visit with a specialist or even tell you that you’re just fine. But in many cases, this first visit turns into an administrative visit where tests are ordered, a history is taken and you are told to come back when all the results are in.  
 
But here’s how it works in my office.  When a new patient calls to make an appointment, my office collects the patient’s information, tests, symptoms and any other relevant information over a secure Internet line.  This is before the patient has even made an appointment.  Once I review the chart, then I call the patient at home to fill in any missing details and decide whether I need to see them, send them to a specialist or collect more information. It’s a huge advantage for everyone involved.    
 
By communicating with a patient online via a secured Internet connection in advance of an office visit, patients can ensure that their doctors have all the relevant information to make an informed decision about next steps. They don’t need to devote their valuable time to a lengthy and sometimes difficult to schedule first appointment filled with administrative details. Doctors can review symptoms, lab work and scans before you even enter their office. Wouldn’t that be a dream? Well, it doesn’t have to be. I don’t have to be the only physician operating in the 21^st century.  Physicians currently have the tools to make this a reality.  A robust broadband Internet connection and a computer are all that is needed for doctors to implement this Internet based evaluation system for new and follow up patients.
 
In addition to evaluating new patients, I also use the Internet to counsel patients through a range of symptoms and problems -- often either requesting that a patient come in right away or telling other patients that a several hours long drive to see me is really not necessary. I’ve also been able to schedule other more critical cases for faster surgeries because of pre-evaluation.  
 
Better quality of care is not the only benefit of this new way of visiting your doctor. Online doctor’s evaluations also have the potential to save on time missed from work, the need for babysitters and potential visits to emergency rooms.
 
And unlike phone calls to the doctor and email exchanges with your physician, a thorough health evaluation online using the full spectrum of services available through a broadband Internet connection such as high resolution images and video sharing, can sway physicians fears about providing incomplete medical advice.  With those benefits, hopefully soon more patients will be hearing, “take two and email me in the morning.”