To discuss e-visit experience in neurology clinic at an academic center.

Messaging health care providers via the portal has become a popular way to seek medical advice. Some of the MyChart (MC) messages require time & expertise of the providers, for which there is no compensation. E-visits are non-face-to-face, billable, patient-initiated communications with the provider using secure messages & questionnaires.

We deployed an e-visit pilot in February 2023 for established patients. When a patient sent a MC message, a provider could determine if it qualified for an e-visit. Some of the qualifying reasons included medication adjustment or side effects, change in existing medical condition, or a simple non-urgent question relating to their medical illness. Providers reviewed the MC message, pertinent medical records, interacted with clinical staff, developed management plans, generated management recommendations, and subsequently communicated with the patient via the portal.

Data was collected from 02/2023 to 08/2024. Total volume of e-visit orders was 789 and completion rate was 74.83%. Neurology clinic was the leading user at 437 e-visit orders with completion rate of 76%. Most popular reason for referral was “medical advice”. Other reasons for e-visits at our institution included pink eye, cough, UTI, rash, vaginal discharge, COVID, travel advice, and IR drains. Average wRVU per e-visit encounter was 0.49. Reimbursement was $23.31 per e-visit. Of all encounters with dropped charges, 4.6% had a portion paid by the patient, of which 80% paid < $50.

E-visits value the work done by providers and allows for compensation for non-office encounters. It improves access to care and allows for more appropriate conditions to be seen in the office.