Another Use for Google Wave: Therapy

January 5, 2010

There the article, “Poll Reveals Havoc of Unemployment  on Workers and Family”, in the New York Times that reminded me of an article I read awhile ago about video conference or virtual therapy for soldiers, which has been a topic in the news lately. More often, it seems, in the wake of the Fort Hood shootings. There are also been articles on the long-term unemployed struggling under burdens no one expected, and then a Wall Street Journal article out today, “Studies: Mental Ills are Often Overtreated, Undertreated” that got me thinking: What about Google Wave as a tool for counseling?

Let that sit for a minute while you think of what normally qualifies as “counseling” or, to be less confusing, therapy. “Counseling” is a term that gets tossed around by many different groups, and thus has many different meanings. College counseling. Credit counseling. Legal counseling. You get the idea. “Therapy” is usually distinguished by another description or qualifier, like “physical therapy.” Without such a distinction, it usually means psychotherapy.

Therapy falls under a favorite health care insurance term: “pre-existing condition.” And seeking treatment for even the most minor of issues, like job transition stress, can be considered grounds for denial. Most health insurance plans don’t cover therapy anyway, or cover such a small number of sessions it is not worth submitting claims. Psychologists and other therapists still take insurance, though, but many do not for a variety of reasons. I never quite understood that until my own battle with individual insurance coverage, which you know has been an enlightening experience on many levels. It’s kind of ridiculous that “health” is not an all-encompassing phrase. It has to be divided into “physical health” and “mental health,” with “physical health” receiving the majority of coverage and “mental health” being an after thought.

After coming across the above mentioned articles, meshed with the chaotic mess of health insurance, I found myself thinking Google Wave, along with Skype, might provide a low-cost, not to mention more convenient, alternative to the standard form of therapy. Standard form as in showing up at an office at a specific time to discuss a topic (or topics) for a 50 minutes (though you pay for 60, I think). And there is that potential hazard of being “seen” though I think in this day and age, no one would pass judgment. We could all benefit, on some level, from therapy, no?

Continued talk of budget cuts, especially in Illinois, make people nervous. Some service is other is always on the chopping block, and our support systems are failing, failed or on life support. Take the CTA, the way most people get around in Chicago. Instead of worrying about your bus route getting cut, or service reductions, both of which would impact your ability to get to the office of a therapist, making therapy a “luxury” instead of a “necessity,” wouldn’t it be nice to just plop down in front of your computer at home? Log into Wave or Skype and start chatting for 50 minutes, then sign off and move on with your day. Or call it a night.

Of course, there are a few barriers. Not everyone has access to the Internet, and probably wouldn’t feel comfortable Skyping from the library (if Skype is even accessible from the library). Or even using Wave since, well, Google would know more than you care to admit. Yes. That’s right, the big “P” as in “privacy.” Patient confidentiality. Not necessarily a guarantee if using Skype or Wave or any other form of electronic communication. That is precisely why the profession is slow to adopt email. But if people willing type information into Google that they wouldn’t dare share with anyone else (so claimed a CNBC segment about Google), then using Wave for therapy does not seem that far a stretch.

This aversion to technology is bothersome and annoying. Don’t get me wrong; I understand why. However, it is time to overcome that aversion in the name of better care and better service. Someone, undoubtedly, will play the “eye contact/facial expression” card, arguing that you just can’t provide effective therapy if you aren’t able to read the nonverbal cues, or hear the tone of voice. I beg to differ, especially since Skype has video capability.

And not all therapists have an aversion to technology. Do a couple Google searches and you’ll find those who have built sites around email therapy, or some kind of online talk therapy. Moving to Wave wouldn’t be too difficult, especially if Wave can be hosted on their own servers instead of Google. May not matter. No doubt all email communication contains a lengthy disclaimer at the bottom.

Perhaps Wave and Skype are not the best tools for long term therapy, but I’d wager them to be effective for short term therapy. Alas, we won’t know until some people somewhere try it out. And that requires a therapist and a patient (participant?), or a few, to try it and see what happens.

I’ll let them figure out the whole issue of billing/payment. PayPal seems the obvious choice, or perhaps industry standard billing methods still apply. I bet there’s a way to better qualify (quantify?) that, and streamline it as well. Now wouldn’t that be something?

I’m curious to see what people think of this. No doubt there are other uses for Wave in the medical profession, and many other professionals, as well. Merely scratching the surface, as they say, no?

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About Shopping Around for Health Insurance

December 11, 2009

There is a helpful article in the New York Times today, “Steps to Take Before Cobra Subsidy Ends”, which lays out some tips or suggestions to maintain your coverage while Congress debates on whether or not to extend the subsidy. It points out that your COBRA payments will go up, and that it is better to pay the full amount than let it lapse.

That’s good advice. Letting your insurance lapse creates a new set of issues that are next to impossible to avoid or untangle. There is a grace period, usually not more than 90 days, which is about three months. Remember, though, that applying for an individual or family health plan can take 30-40 days to process, and applying does not guarantee you will be given coverage.

And it is the lack of guarantee that gives me pause when I read:

time to shop around for health insurance alternatives that may be more affordable.Check ehealthinsurance.com and healthplanone.com for general pricing information from carriers that provide individual policies in your area.

You may find a plan that is perfect for you (and your family) at an affordable price, apply and get denied. The denial puts you right back at square one. And that is a frustrating, demoralizing place to be.

To avoid, or at least improve your chances of getting coverage, apply to more than one plan that you like and/or find a respectable health insurance broker. Or check out organizations like MediaBistro, the Freelancers Union, the National Association for the Self-Employed or something similar that offers health insurance to members. They have often brokered good deals for members already, much like your former employer. And if you’re a lawyer, try the American Bar Association.

When it comes to health insurance, there is something to be said about being part of a large group. MediaBistro, Freelancers Union, NASE, ABA and others put you back in a group, and sometimes that can lead to more than just health insurance coverage.

Take the time now to investigate your options and get the ball rolling on applications. It will make a difference.


Health Coverage Frustration

October 26, 2009

OK. I’ve done my best to stave off a rant on health care coverage, especially since I’m sick and tired of hearing people, ahem, politicians, health insurance companies and the like, put forth the same arguments for and against health care reform. They all take a rather narrow-minded view of health insurance reform, and are completely ignoring something basic: the health insurance application process.

If you want everyone to have coverage, then you must simplify the application process. Case in point: me.

Just to recap: I got laid off in April 2008, making me ineligible for extended benefits, or what I’ve referred to as inadvertently being ahead of the pack. Knowing my COBRA insurance would run out after 18 months, the maximum length of time for coverage, and would not be extended under new legislation since I was laid off well before the masses, I applied for individual coverage. I’m a fairly health individual, take 0 prescription drugs but like to have a plan in case of the unexpected, especially after getting hit by a CTA bus. I came away from that unscathed, but with a profound sense that accidents happen (the bus hit me, not the other way round) and I may not always be as fortunate.

I did some initial research, and I found that I still liked my current carrier and that an individual plan would save me roughly $300 a month over COBRA. I momentarily kicked myself for not switching earlier, but there had been the chance of gainful employment that brings with it health insurance coverage. Plus, it is the 3rd time I’ve had this particular health insurance carrier so my records are already with them. In triplicate, actually, which I find rather silly but didn’t know exactly how ridiculous this was until I applied for individual coverage.

Logic dictates that since I am already insured by said carrier, indeed have been insured by said carrier, switching from an employer to an individual plan should not be equivalent to walking through a mine field shackled and blind folded. They have my information, they have my records, they have what is needed. When I called to inquire about switching, I asked if they can just transfer my records from an employer account to the individual account I wanted to set up. The person laughed. Nope. Doesn’t work that way. I have to re-apply and re-submit my medical records. All of them.

Now keep in mind I am not changing carriers; I am using the same carrier. They have my records. The records have to be submitted for claims, and there have been a few claims since I have been insured by said carrier. Bottom line: they have the records.

Apparently, though, no division communicates with any other division. They cannot simply move my records from the “employer” division to the “individual” division, and then check for discrepancies and make records requests for incomplete information. No. I have to go through a completely separate, wonderfully detailed application process. The majority of the questions, by the way, would have been answered if they had been able to move my records. And they clearly have access to my claims history because they read it back to me over the phone, and inquired about each one. My answered verified what they had on their screen.

So this is where my frustration has started to…OK…has boiled over. If they can pull up my claim information, why can’t they then review my records? Why is it that I had to sign 4 records releases? 4! And here we are, more than a month later, and I am still waiting for the underwriter to approve or deny my application.

Yes. That’s right. Approve or Deny. Without employer coverage, there is the possibility of being denied coverage. If I’m denied coverage, I’d hate to see what happens to people who have submitted 0 claims and also take 0 prescriptions.

That’s not what annoys me, though. What annoys me is the silos. How on earth can there be any kind of meaningful health care reform if health care insurance companies cannot even share information within their own walls? And if they can’t even do that, how can they possibly field requests for information from out-of-state hospitals? Seriously. What happens if I am in a serious accident or have to be hospitalized in Arizona, Florida, Maine or *gulp* overseas? If it takes more than a month simply to request records and “process” an application, how long does it take to send my information to a hospital somewhere else?

I talked about this whole medical records transfer issue in a previous post on electronic medical record portability, but this lack of internal communication makes me think the problem runs much deeper than anyone, myself, Congress, anyone, originally conceived.

My point, though, is that if health care coverage is to be granted to everyone, then Congress must force the health care insurance industry to simplify its process. So if a person like me, who is KEEPING THE SAME INSURANCE CARRIER, applies for individual coverage, the process should happen much more quickly than if I were to change carriers.

Otherwise, shelve health care reform and focus on creating jobs as that will be the only way the rest of us will be able to obtain health care coverage.