Web messaging boosts clinician productivity.(Practice Trends)

SAN FRANCISCO -- Giving patients access to online communications with physicians and their offices not only decreased phone calls but also decreased the volume of all messages and increased revenues in a controlled study, said Eric M. Liederman, M.D.

The idea that incorporating Web messaging into practices can boost clinical productivity is "a very controversial conclusion. It took my institution a couple of years to really believe it. Now they do, because they've not only seen my data, but there's a lot of anecdotal evidence as well," said Dr. Liederman of the University of California, Davis.

He and his associates studied their institution's efforts to introduce Web messaging, which allows messaging through a secure Web portal and which differs from e-mail in a number of ways. (See box.)

Over 13 months, the volume of phone messages dropped significantly, and the volume of phone and Web messages also dropped significantly at a clinic with Web messaging while volumes remained unchanged at a similar clinic used as a control.

"Why? Because phone calls create more phone calls" as providers and patients play phone tag, he explained. "All of that goes away with electronic messaging."

With the increased efficiency, the clinic with Web messaging was able to handle 11% more patient visits per day than the control site. "Annualized, that's a lot more access for patients. We're in a part of the country that has fewer doctors than we need. This is a big help." Dr. Liederman said.

Similarly, physicians at the site with Web messaging generated 10% more relative value units (the method of determining compensation based on productivity) each day, compared with physicians at the control site. That translates into extra revenue of approximately $19,000 per physician per year, he said. The true gain would be higher today, because at the time of the study, the physicians were not reimbursed for time spent on Web messaging, but now reimbursement usually is available, he added.