Why do we not pay for physicians, in the ambulatory environment, to use information technology to extend chronic disease care beyond office walls? Theoretically, a mixture of IVR, e-mail and WEB would allow proactive, preventive care (badly needed with chronic disease) to take place.

We are sitting on a “tipping point” in health care delivery. What are the barriers to shifting the WEB based and IT enabled disease management programs of third party payers to physicians?

Let’s consider e-prescribing (ASP version being given away free by Allscripts and partners). Patient drug noncompliance (especially blood pressure) can be suspected in claims data of members who had the drug paid and then claims for it stopped. But how much better will it be if their physician knows, can ask why they have stopped, maybe prescribe one they will better tolerate and/or address their misconceptions about their need for it?

I see physician adoption of e-prescribing not as an end in itself just for Formulary compliance on the part of Payers. More importnat is how it can change communications between patients and physicians.

only retain the patient but bring them in at the optimum time versus reative to patient crisis.
Pharos and Allscripts (some components) are examples of going beyond the walls and attempts to cause more fruitful, earlier cost effective patient physician interaction. I am sure there are others.
I would welcome a discussion on ambulatory provider driven chronic care management – especially how to successfuly make a ROI on it – top line growth as well as cost control.