In my previous post Dr. Facebook will see you now, I discussed a new trend in healthcare delivery where patients interact with their doctors through a Facebook-like platform called Hello Health that allows Instant Messaging, video conferencing and open scheduling. While this trend has been hailed the “future of healthcare delivery,” it has its critics and limitations.

To start with the specifics, Hello Health is not the solution that will bring access to the uninsured. It is true that half its patients are uninsured, but these are not the poor uninsured that everyone is talking about. Rather, they are the so-called “young invincibles,” i.e. people that could afford insurance but do not buy it because they think that they are healthy enough. Therefore, a practice like Hello Health makes a lot of sense for them since it charges only $35 per month and after that payment is based on utilization ($50-$100 for an IM session or phone session and $150-$200 for in-person visit or house-call).

But beyond Hello Health and its membership system, there are growing concerns about any kind of social network allowing transfer of patient information. First of all, there is the issue of privacy. Sensitive patient information being transferred through social media can fall into the wrong hands of hackers and therefore violate federal privacy laws.

Another main issue is that of liability: what happens when a doctor makes a wrong diagnosis or prescribes the wrong medicine for the patient after a quick IM session? A lot of doctors suggest that nothing can replace in-person physician examination of the patient. Others suggest that specific protocols and standards should be put in place to govern patient-physician internet-based communications.

And yet another issue is physicians’ willingness to learn about these new technologies and to invest in them. While the majority of young and middle-aged doctors are active Facebook and Twitter users, the truth is there is still a generation of doctors practicing in our healthcare system that still don’t know how to turn the computer on.

Internet-based communication media have a huge potential in shifting control of healthcare delivery to patients and actively engaging them. But unless the issues of privacy, standards of care and willingness to adopt new technology are resolved, they are likely to be limited to a few sleek offices in Brooklyn like Hello Health.