My first assignment: E-Visits

My first assignment has been quite interesting! I am working to develop content for electronic patient visits, or "eVisits" for short.

What is an eVisit?

It's a structured interaction between a patient and a physician, which takes place over the computer. Epic users can log in to their medical record, and send a message to their physician describing a health concern. The physician receives an electronic message and responds accordingly.

Sound worthwhile? There is pretty compelling data to suggest that patients want to have the opportunity to seek treatment from their physician online. There is also support for the concept within the medical community. According to the Future of Family Medicine task force, up to 40% of office visits could potentially be managed electronically. This would save time for the patients, cut costs, and free up physician time for other activities.

Certainly, there is complexity involved on several levels.

Should the physician be reimbursed for this service? Absolutely! Some of the forward-thinking third-party payors are beginning to pay for eVisits, but there is a long way to go to make this part of the mainstream coverable services from all the major providers.

Is this service secure? We have techies working on that.

Are eVisits efficient and effective? That's where my role comes into play. The ideal eVisit will be focused on a defined topic, and collect enough information for the physician to make a clinical decision in a single exchange. If it requires more than one e-mail exchange to resolve the eVisit, then it is no longer convenient for the patient or the doctor. So, my role is to design the questionnaires for specific topics. The goal is to ask all the necessary questions to confirm the suspected diagnosis, and make sure something worse isn't happening, but to keep the questionnaire short enough that the patient can finish it comfortably.

Designing eVisit questionnaires is a fun challenge. It combines medical knowledge, clinical experience, decision-making, and technology. And, it is an important innovation which will move medicine forward in new directions in the years to come!

Most of my first seven weeks has been invested in training... a long story in itself. I'll describe that process in another entry in a week or two.