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Patient Portal and PHR Info
PHR's and Patient Portals Examined

Support for E-Visits – CPT Code 99444 and 98969: 9 of 10 Critical Features of Patient Portals


Patients love the convenience of e-visits when available.  The best demographic for e-visits are patients who live far away from their clinics, have kids, or who don’t want to spend 2-4 hours for a trip to the doctor when all they need is a quick answer or diagnosis for a minor symptom.  Some possible symptoms could be common cold, sinus infections, urinary problems, cough, diarrhea and back pain.

Providing a route for patients to take that does not require them to come to the clinic benefits them and your organization.  Many organizations find that overall utilization drops when e-visits are implemented, some places by as much as 25%.  This makes e-visits a very interesting proposition for insurance companies, although few actually re-imburse for them currently.

E-visits, with the proper functionality, also allow the patient to update their allergies, vital signs, and history information.

E-visits are the way of the future for healthcare since they can help lower costs by decreasing utilization and improving care efficiency.  Patients also enjoy the lower co-pays that e-visits provide.  As more and more patients look to lower their healthcare costs they will increase usage of alternative options like e-visits and nurse only visits.

Providing e-visits allows the standard healthcare organization to offer a product that can compete on price with the retail clinics that are popping up in strip malls and Walmart.


A patient portal offering e-visit functionality needs to provide several tools to make the e-visit flow usable.   For starters, most states require that a patient is notified up front that they may be charged for the visit so having a terms and conditions agreement option is critical.  The phr should also allow for the entry of history, allergies, vitals and other information collected during a standard office visit.

Since the information is provided by the patient, the data should not immediately sync in with the permanent chart until reviewed by a clinician or physician.  Since the CMS code 99444 states that a timely response is required workqueue functionality must exist so that the e-visits are reviewed by physicians quickly.

Code 99444 also states that an e-visit can only occur with an existing patient, once in any given seven-day period.

Questions to Ask

To Vendors

Is there integration to process credit card payments?

Can questionnaires be customized based on the symptom the patient enters?

What kind of logic can be configured to route the e-visit request to the appropriate provider?

What tools are available to the provider to work the e-visits quickly and efficiently?

Are there customizable restrictions available to help comply with the laws, such as only allowing one e-visit in a seven-day period?  Or are people working the e-visits required to check for compliance?

For Patients

How much does it cost?  (most places charge $30-$35, but the majority of patients feel like they should be cheaper or that they should be free)

How long will it take to hear back?

Can I get a prescription via an e-visit?

Posted by Aaron Carlock on November 5th, 2009 :: Filed under Choosing a Patient Portal
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