Implementation of e-visit billing for responding to patient-initiated messages that require substantive medical decision-making is associated with a modest decrease in patient-initiated portal message volume, according to a study published online Dec. 31 in the Annals of Internal Medicine.
Shannon M. Dunlay, M.D., from the Mayo Clinic in Rochester, Minnesota, and colleagues examined the effect of billing eligible patient-initiated portal messages as e-visits in a retrospective observation pre-post comparison and prospective survey. The volume of patient-initiated medical advice message threads was compared preimplementation versus postimplementation of e-visit billing. An online survey was used to assess health system provider perceptions of e-visit billing.
The researchers found that the volume of patient-initiated medical advice message threads decreased by 8.8 percent in the six months after e-visit billing implementation (Aug 18, 2023, through Feb. 18, 2024) compared with the same dates the year prior. Overall, 5,183 medical advice messages (0.3 percent) were billed.
Patients who proceeded with sending a message had no difference in seven-day use of emergency services compared with those who did not send a message after viewing the billing disclaimer on the patient portal. Overall acceptance of e-visit billing was reported by providers, but they expressed concerns relating to increased workload with the current process.
“As digital health care practices continue to evolve, opportunities exist to optimize interactions to maximize patient satisfaction and outcomes and minimize care team burden and burnout,” the authors write.
More information:
Shannon M. Dunlay et al, Implementation of Billing for Patient Portal Messages as E-Visits in a Large Integrated Health System, Annals of Internal Medicine (2024). DOI: 10.7326/ANNALS-24-01711
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Modest decline seen in portal messaging with billing implementation (2024, December 31)
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