Many patient -physician interactions do not need to be face-to-face.  “How are you doing?”  “Tell me more about that symptom.” “Adjust the medication dose.”  “Try this and let me know how it goes.”  “Read about these options and let me know what questions you have….” …and so forth.

A trip to the clinic to see the doctor can take 3+ hours for a patient to accomplish. Not convenient (and increasingly not affordable, especially when you figure in time that could be spent working or playing).  We think it is important to start out with a face-to-face interaction, because that is how humans get to know each other and develop a trusting relationship.  But for a lot of problems, much of the communication can be done virtually, in a way that is convenient … and affordable.

What is an eVisit?  An eVisit is an electronic secure messaging interaction that takes the place of a traditional office visit. A secure message occurs within the electronic medical record- it is encrypted and secure as your bank (or more so).  Email can be used to notify you of a message, but it is not a safe place to put medical information.

A cool thing about eVisits- is that patients are directly putting information into their medical record, in their own words.  eVisits become part of the medical record, your medical record.

eVisits can be conducted from anywhere and at anytime.  You could be on the other side of the world in New Guinea, or away in college.  You could be camping …with a smartphone.

More and more insurers have been reimbursing health care providers for eVisits and now there are billing codes for eVisits that correspond to office visits.

Although only a small fraction, so far, are eVisits, HealthPartners is receiving nearly 10,000 secure messages from patients each month.

We hear that patients love the convenience and connectivity of eVisits.  With experience, more and more doctors are embracing eVisits …while some remain skeptical. For doctors there is data that eVisits are more time efficient than phone interactions, and as is always the case, one must use judgment on what problems are appropriate for an eVisit- if you are having stroke or heart attack symptoms call 911!
Secure messages can be about anything, but eVisits are about medical problems and replace office visits. For an eVisit insurers generally require the following:

• Evaluation/Management Service provided by a physician (or other qualified) to a patient using Internet resources, in response to the patient’s online inquiry

• Advice, diagnosis and/or therapy that previously would have required a face-to-face interaction in the office

• The patient and provider must have a previously established therapeutic relationship

I conducted my first eVisit as a patient recently and was immensely convenient- I had physical therapy arranged, arranged lab tests at my convenience, and had a medication prescribed- all on line, and with a doctor I know.

We will be trying some different approaches to eVisits, along with other innovative ways to access healthcare.  Try an eVisit and tell me about your experience.

The following is from a recent presentation at the Minnesota Epic Users Group summer meeting- a topic of increasing interest in the medical community:

John Butler, MD