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Payment, workload are barriers to increased e-communication


Outdated payment models and concerns over increased workload requirements are preventing medical practices from embracing electronic communications with patients.

Though medical practices know the benefits of increasing electronic communication with patients, it is still viewed as a disadvantage, according to an August 2013 study conducted by Health Affairs.

In 2008, Health Affairs found that only 7% of medical practices were using electronic communication. The journal interviewed six national and regional medical group leaders, and found that out-of-date payment models was a leading cause that prevented practices from embracing electronic communication.

“Unfortunately, traditional payment models are not equipped for a shift from care provided predominantly in the office to care provided electronically,” the report stated.

Only one plan charged patients for e-visits, where a physician provided a clinical decision via phone, e-mail or Web video that would have normally been provided in an office. This group negotiated with private payers for reimbursements for e-visits, and they were valued less than face-to-face office visits. Others that offered e-visits under fee-for-service models were not paid for.

Another group initially charged patients an annual fee of $60 for unlimited electronic communication with physicians, but eliminated the fee when a competing group began offering similar services for free.

Also, practice staff said that electronic communication increased their workloads. Though some participants reported answering up to 50 emails a day from patients, many did not didn’t have a specific time delegated to electronic communication.

Group leaders reported benefits of electronic visits and communication with patients that included an increase in patient satisfaction, convenience, efficiency and higher quality care with better outcomes.


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