Looking Forward: 4 Boons Coming Your Way in 2014

Leigh Page

Disclosures

January 02, 2014

In This Article

New Ways of Seeing Patients

2. Physicians' Growing Use of E-visits With Patients

When Stage 2 of the federal meaningful use requirements mandated setting up a secure patient portal, it opened the door for "e-visits" -- including emails and, in some cases, real-time videoconferencing with patients. The portals are connected to practices' electronic medical record systems, which usually enable secure email messaging.

In the past year or two, Grove Medical Associates, a 4-member primary care practice in Auburn, Massachusetts, has taken advantage of the email feature in its portal. E-mails between physicians and patients are now an established part of its care model, according to Gail Cetto, RN, the practice's manager.

"The physicians have found it to be an easy way to communicate, and patients like the convenience," Cetto said, adding that the extra contact with patients will likely improve quality of care. However, none of Grove's major insurers pay for e-visits, which is still a common problem for many practices nationwide.

Twenty states -- including California, Arizona, Georgia, Texas, and Maryland -- now require insurers to cover e-visits,[1] according to the American Telemedicine Association (ATA), a trade association for telemedicine vendors. But even in these states, some insurers have interpreted the law very narrowly, the association confirmed. For example, Aetna[2] will pay for e-visits only if they are done through RelayHealth, which charges physicians an undisclosed fee for the service.

In addition, some physicians find that answering patient emails can be very time-consuming, which is a major concern when the practice cannot be reimbursed for them. Before initiating e-visits, practices are advised to explore reimbursements and assign a nurse practitioner to triage emails for physicians.

Despite the current snags in insurance coverage, Jonathan Linkous, CEO of the ATA, predicted that most e-visits will be reimbursed in the near future and strong patient demand will force physicians to provide the service. Emailing instead of in-person visits will eventually be like "using an ATM card rather than going into the bank," he said. "A lot of the time, you don't need to go in and see the doctor face-to-face."

He added that practices that make patients wait for an appointment rather than let them email will have to compete with such companies as Teladoc and MDLIVE, which employ physicians to give patients immediate advice via teleconferencing.

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