Electronic Medical Records and the power of the internet has created the opportunity for e-visits, where physicians and patients can communicate virtually instead of face-to-face. In an e-visit, the patient logs into their personal portal and answers a series of questions about describing their symptoms. This information is sent to the physician, who makes a diagnosis, orders necessary care, puts a note in the patient’s EMR, and replies to the patient via portal, all within a short amount of time.
E-visits are a part of the telehealth market. The broader telehealth market also includes video visits, remote monitoring, and alerts and notifications, and more. There are plenty of benefits to e-visits. The biggest for patients are convenience and efficiency. If you’re sick, you no longer necessarily have to travel to the physician’s office, you can receive a diagnosis and treatment right from your home. Or, if the physician’s office schedule is full, it’s still possible to get their input versus having to go to urgent care or the emergency room. For physicians, e-visits make it easier to keep up with all of their patients, and allow them to more quickly deliver care. There is also the potential for e-visits to reduce medical costs, as insurers determine the best way to incorporate and pay for them.
Patients go to the Emergency Room today to get treated for ailments that should be addressed in an ambulatory primary care setting. The primary reasons why people go to Emergency Rooms is that there is a significant backlog and wait time to be seen. With the introduction of e-visits, it allows ambulatory providers to have more flexibility in filling no-show slots or turning after-hours on-call time into billable patient care. By taking the ambulatory ailments out of the Emergency Rooms, it will significantly drive down medical costs that will in turn reduce insurance premiums. Some providers, like Kaiser and HealthPartners, have already achieved savings because they insure many or all of their patients and employ their physicians, who get paid the same whether they communicate with patients face-to-face, over the phone, or online. Any revenue lost on the provider side with the use of less expensive e-visits is more than made up on the insurer side as patients are kept healthier, reducing the costs of care.
“I think in five or ten years, we won’t be surprised that most of the care will be virtual. A lot of patients or clients, consumers are going to the health systems, where healthcare will come to them, wherever they are. It’s a similar analogy to banking, I don’t have to go to a bank now to deposit a check, I can use an app, take a picture, and the money gets deposited. I think it’s going to be very much the same in healthcare. We’ve already seen the trend and I believe, in a couple of years, we’ll see telemedicine, secure messaging with doctors, becoming main stream. – Ashish Atreja, Chief Innovation & Engagement Officer, Mount Sinai Medical Center
Additional benefits include:
- Reduction in Emergency Department throughput by lowering the number of non-emergent/low acuity visits to the brick and mortar practice resulting in a higher efficiency ED
- Ability for patients in rural areas with limited providers or specialties to seek second opinions and consult with specialist providers
So how do they work? Most e-visits don’t result with direct interaction with a physician. Instead, the diagnosis is made through forms, questionnaires, and photos submitted by the patient. For example, patients suffering from allergies or an earache can receive a diagnosis and, if required, a prescription, after completing an online form.
Patients that use Epic’s MyChart can request an e-visit with a certified nurse practitioner or physician assistant and get a fast response. In an Epic case study at Cone Health, the average response time was just 37 minutes. The process for requesting an e-visit through MyChart is simple. After logging into your account, you’ll select the e-visit tab and it will ask you to choose between asking a general medical question or requesting an e-visit. Once you choose e-visit it will bring you through a set of authorizations, depending on the organization, including terms and conditions, and payment. You’ll then fill out a short questionnaire on your reason for scheduling the e-visit, indicating your provider and pharmacy, any medications you are taking, and any other pertinent questions. You even have the option to upload an image. Once you’ve submitted the e-visit request you will be contacted with next steps, based on your answers.
According to post-service surveys at Cone Health, 63% of patients who utilized the e-visits feature on MyChart would have otherwise gone to an urgent care or ED – saving time and reducing costs for Cone Health, insurers, and patients. Over 90% of patients who had MyChart e-visits said they are very likely to recommend them to friends and family. Usage is growing each month – now at over 100 e-visits per month and expected to triple by this time next year. Providing more convenient and less expensive healthcare services through e-visits is quickly becoming a reality as the pieces of the technology puzzle fall into place.
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