Health Wise: Dr. Janet Hurley on eVisits and embracing the digital age of medicine


I have been excited to see physicians and patients embrace the digital age of medicine. Due to privacy concerns with electronic medical records and adoption of electronic methods for care delivery, it has been delayed beyond most other industries. Computer automation of medical care was inevitable, and the time is now upon us.

Many physician groups offer secure email with patients. This allows patients to send questions or refill requests after normal business hours when the patient is at home, free of the hustle and bustle of daily activities. Many groups also submit refills electronically, which improves accuracy, reduces errors and improves efficiency. Some medical groups are now also offering virtual office visits, also known as eVisits.

What is an eVisit? It is a computerized method to get advice and treatment from your care provider by answering a series of questions about a topic and receiving advice, and sometimes medication, in return. This type of visit is considered “asynchronous,” meaning the reply you get from your doctor may be several hours later, but is still done within a convenient amount of time. The cost for an eVisit is usually about the price of a standard insurance copay, without having to miss work or school.

Usually, these visits are limited to the established patients within a practice, although some organizations will provide care to all people who request it. Patients who have a primary care physician who offers this service usually can access these eVisits from the secure website provided by their doctor.

Not everything can be done via an eVisit, but some common things can be addressed safely and appropriately via this method. Examples of common ailments that can sometimes be managed by an eVisit are bladder infections, pink eye, sinus infections, low back pain, ADHD follow-ups, and other similar, nonlife-threatening conditions. One good guideline for eVisits concerns the urgency of the patient’s request. If a patient feels they cannot safely wait up to a day for a response, the eVisit is not the way to address that concern.

Usually eVisits are offered during normal business hours, because the doctor must be actively logged into the electronic medical record to see the eVisit request has arrived. Most providers respond within one business day.

These electronic visits are offered as a more convenient and lower cost way to provide safe care for these milder conditions, freeing up time within the physician's office for more urgent and complex care needs.

The eVisits differ from regular phone calls or emails for advice, because the eVisit requires the patient to answer several specific questions which provide valuable information, enabling providers to identify high-risk situations and act accordingly. Sometimes the right thing to do is to cancel the eVisit and ask the patient to come in for a face-to-face appointment. Usually when that happens, the eVisit charge is waived.

The next thing we will see in our region is Video visits, in which the patient will communicate directly with their care provider via a live video feed, using secure technology to protect the patient’s privacy. While not yet available locally, the community can to expect to see that soon.

Anyone who is interested in learning more about virtual office visits or video visits can look on their doctor’s website to see if this service is available. If so, there should be a link directly from the website. While there are some companies based outside of East Texas who can provide this service, it is the opinion of many that care is best rendered by the patient’s personal physician or partners, who have access to the patient’s full medical history and electronic medical record. Having care provided by doctors locally helps to ensure the same patient protections afforded by the Texas State Medical Board.

The new digital age of medicine is not something to be feared. I am excited to see these modalities of care be available to patients in our community.

Dr. Janet Hurley is operational chief for primary care of the southern region for Christus Trinity Clinic, practices family medicine at the Herrington-Ornelas HealthPark in Tyler and is president-elect for the Texas Academy of Family Physicians.

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