Who is doing digital health care right?

Question

Folks, are any of you getting digitally enabled health care that feels efficient and modern? In the USA or outside? I'm in the US with a large managed health care company and after an injury this week felt like they aren't really much better than any old independent practice. My doctor said my ankle _might_ be broken and a podiatrist would reach out with a recommendation. I got a generic email from podiatrist asking me to schedule an appointment (podiatrist is with the same company 1 floor down. Next appointment is more than a week away). This seems nuts to me? I can imagine a very simple workflow tool that lets a doctor send some image/test result to a specialist or a queue of specialists who take a look and give their opinion. How can a large integrated health care company not have something like that in place? Choose to behave like different offices that happen to share the same building instead?Is anyone getting that level of digital integration and efficiency? Is this too much to expect?Thanks!

boas · Accepted Answer

In a hospital or healthcare system, all of the doctors can generally see all of the imaging, labs, and notes for all patients. The problem with "curbside consults" -- where another doctor provides an immediate opinion without seeing the patient -- is that 1. The other doctor often doesn't get the full picture without doing a full evaluation. 2. Increased malpractice risk 3. It's not billable.
I'm a doctor, and in my own experience, my first impression from just seeing the images and talking to the other doctor is sometimes completely different from my final opinion after reviewing the chart and seeing the patient.
Wait times are also a problem, because hospitals and clinics like to operate at close to 100% capacity. There are huge fixed costs in a hospital, and hospital profit margins are often <5%, so that's why they have to operate near capacity.