Association Between Billing Patient Portal Messages as e-Visits and Patient Messaging Volume

Abstract

This study evaluates the adoption of clinician billing for patient portal messages as e-visits, prompted by significant increases in patient messaging after the onset of the COVID-19 pandemic.

Trends, Distribution, and Impact of Pediatric Messages in a Large Health System From 2019 to 2021

“…In this study, the high-volume group received 3 times the medical advice messages as the low-volume group; mean message volume was similar to another study . Within groups, time on the EHR outside clinical hours did not increase, perhaps because visits decreased.…”

“…Discussion | In this study, the high-volume group received 3 times the medical advice messages as the low-volume group; mean message volume was similar to another study. 5 Within groups, time on the EHR outside clinical hours did not increase, perhaps because visits decreased. As office visits rebound, health systems may need to support pediatricians' ability to handle their workload by charging for messages, 5 dedicating time to responding, offering scribes, 6 or adjusting panel sizes.…”

Comparing Physician and Artificial Intelligence Chatbot Responses to Patient Questions Posted to a Public Social Media Forum

“…This scale and fine-tuning by human examples 4 have enabled the relatively simple autocomplete concept to exhibit surprising emergent properties of complex language capabilities including summarization, translation, and question answering, even without specific training for such tasks the way most other narrow AI systems work. 5 Especially striking for the medical community is that these systems can now perform at a level that passes the US Medical Licensing Examination, 6 while generating responses to patient questions posted on a social media forum with higher quality and empathy than responses by human physicians, as demonstrated in a cross-sectional study in this issue of JAMA Internal Medicine. 7 The combination of these large language models with a familiar chat interface enables humans and AI systems to engage in a dynamic dialogue through the high-bandwidth yet relatable medium of human language.…”

“…Unfortunately, these strategies can limit access to high-quality health care. For instance, when patients were told they might be billed for messaging, they sent fewer messages and had shorter back-and-forth exchanges with clinicians . Artificial intelligence (AI) assistants are an unexplored resource for addressing the burden of messages.…”

“…For instance, when patients were told they might be billed for messaging, they sent fewer messages and had shorter back-and-forth exchanges with clinicians. 6 Artificial intelligence (AI) assistants are an unexplored resource for addressing the burden of messages. While some proprietary AI assistants show promise, 7 some public tools have failed to recognize even basic health concepts.…”