Doctor/patient survey reveals pros and cons of billing for portal emails
Abstract: https://www.acpjournals.org/doi/10.7326/ANNALS-24-00560
URL goes live when the embargo lifts
According to a brief research report published in Annals of Internal Medicine, policies that require billing patients for emailing through the patient portal may change communication behavior between patients and physicians. Physicians believe patients may withhold important information to avoid charges, and patients may anticipate faster, more detailed replies, viewing it as a premium service. According to the researchers, health systems may want to review the advantages and disadvantages of similar policies before deciding on an appropriate implementation strategy.
Researchers from the Center for Value-Based Care Research, Cleveland Clinic interviewed 13 patients and 16 physicians using tailored questions to understand perceptions of billing policy and its influence on workflow, distress, communication, and quality. Patients and physicians were given separate surveys on the same topic. Their responses showed differences in attitudes and potential behaviors between the two groups. While patients viewed billing for emails as a negative at first, they said they understood that the method could be abused by some. Physicians hoped billing would reduce the number of messages or mean that time would be given within the workday to answer them. Both physicians and patients expressed confusion over billing policy. Patients did not know whether their message would require a little or a lot of physician time and physicians weren’t sure how to bill when multiple actions might be required within the patient record and between patient message requests. The physicians said they may choose not to charge patients with difficult socioeconomic circumstances. The researchers say it is important to consider these potential consequences before these billing policies become widespread.
Media contacts: For an embargoed PDF, please contact Angela Collom at acollom@acponline.org. To speak with corresponding author Jordan M. Alpert, PhD, please email Kathryn Ely at elyk@ccf.org.
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