Back when patient portals were first introduced, one of the original concerns clinicians raised was that they were afraid that they would get too many patient messages and find themselves overwhelmed.
Over time, most stopped complaining about this problem, though I’d wager it was because they simply had worse things to worry about during the painful initial period of EHR adoption.
It may also have been that complaining wouldn’t help. At least in the early days, health system administrators were very excited about giving patients the ability to trade messages with clinicians, as they believed that getting patients to do so was a great way to get them more engaged with their care.
More recently, however, providers have begun to reevaluate their position on charging for medical advice requested via a portal.
For example, a piece in the Chicago Tribune recently outlined a growing movement among hospitals in its region to begin charging for patient requests made through portals such as Epic’s MyChart.
According to the article, an increasing number of health systems in metro Chicago – as well as elsewhere in the U.S. – have begun charging for responses to some types of patient messages sent through portals, typically charging $35 or less.
For example, the NorthShore University HealthSystem has begun billing patients when clinicians respond to some types of messages coming in through the portal, the article said. In so doing, it joined Northwestern Medicine and Lurie Children’s Hospital.
When NorthShore announced the planned charges, it noted that while most patient messages won’t involve a charge, they might be billed for a few categories of response, including questions about new symptoms, new prescriptions, flare-ups of chronic conditions and any other queries that required clinicians to spend extensive time reviewing that patient’s medical history, the Tribune noted.
The health system said that patients on Medicare will pay fees ranging from $3 to $10, while consumers with Medicare Advantage or private insurance might face co-pays similar to those paid for video visits or in-person consultations. Private pay consults for patients without insurance will cost $35.
It’s interesting to note that while the prospect of new charges might frighten consumers, they are unlikely to be affected by these charges if early research is any indication. According to the newspaper, Northwestern Medicine charged fees for less than 1% of message exchanges conducted via its MyChart portal during the first three months after the charges were rolled out.
In any event, with many consumers having gotten used to telehealth co-pays, perhaps the idea of paying for clinical advice via portal messages won’t be a big deal.
