Some may remember the home visit made by the family doctor that became a practice of the past. Then came the phone consultations where the patient called in with a question and the doctor or his nurse called back. Now through an online patient portal, patients can ask questions and doctors can make a diagnosis and prescribe treatment. The American Academy of Family Physicians (AAFP) has reviewed this practice and offered specific guidelines for e-visits.
1. They can be offered only to established patients who have already received care from the physician
2. The procedure must in initiated by the patient who must also agree to the terms and policies for such visits
3. This online electronic communication must take place via a HIPAA-compliant connection
4. All documentation associated with this communication must be registered in the patient’s medical health record
5. A follow-up must be done within a specific timeframe
6. Such e-visits are a billable medical service by the physician
Symptoms that can be safely dealt with include an illness such as sinus issues, pinkeye, minor skin conditions and bladder infections. The patient must fill out a form concerning their symptoms with the knowledge that they will get a response within a few hours regarding treatment. They would then be scheduled for follow up in the office after a specific timeframe.
In general, counseling is limited to those over 12 years of age. Since it is done with the doctor, a co-pay can be charged in contrast to the counseling that is done by the nurse. The consultation must involve the introduction of new information and not just the transfer of something like lab results to the patient. Visual options are becoming available, especially in rural areas, which allow the doctor to examine a simple wound, bruise or rash. In such cases, the doctor can quickly decide whether or not an in office visit or specialist is needed.
As physicians look for innovate ways to increase their productivity and profitability of their medical practice, virtual e-visits are certainly be one method to accomplish this.