E-Visits To Quickly and Efficiently Address Symptoms and Concerns

In our digital age, people have expectations of efficiency and fast turnaround time. Providing a little information and answering a few questions to screen out more serious problems is all patients should need to do for common, relatively low-risk conditions.

In the future, maybe even computers will be able to write a prescription. Prior research around urinary tract infections in the 1980s showed that patients with urinary tract symptoms could obtain and accurate diagnosis very quickly, and have an antibiotic quickly prescribed or called in (a relatively junior faculty member at the time would wait by the printer and add his signature).

Clinician offices are busy managing phone calls and incoming patient portal messages. And on the other end, patients are waiting for answers. Many conditions, from urinary tract infections and yeast infections to back pain, sinusitis, cough, and even requests for birth control could be managed much more efficiently.

Enter the asynchronous visit or e-visit. Rather than having back and forth conversations through the patient portal or playing phone tag, we are beginning to offer our patients a quick way to provide information around a defined set of health concerns or symptoms and obtain some initial medical advice, a prescription if warranted, and/or follow-up instructions and advice.

The goals of this program are to take patient requests for the evaluation and treatment of these relatively common conditions out of the inbaskets of our primary care teams. We have a centralized team manage these, providing a turnaround time of 2 hours, or by 10 am if done after business hours.

On the consumer side, our patients will complete some information about their request/condition through a templates set of questions designed to capture the most important information for evaluation.On the clinician side, we are using advanced tools in the EHR (Epic) to sort and triage patient requests, and to provide clinicians with focused and specific order sets and documentation, such that they can quickly and efficiently help patients and close out the visit.

We are starting with one of the most common — and time consuming — tasks right now, which is the request for COVID-19 testing, evaluation of symptoms, and scheduling of the drive-thru testing. We launched this capability on September 10th, and will be expanding it this week even more. Patients can access the E-Visits for COVID-19 testing directly in the Froedtert & MCW mobile app, or through MyChart.

While e-visits are starting with COVID-19 testing only, we will be expanding to a few more other common conditions later this year, such as urinary tract infections, low back pain, and upper respiratory conditions.

Over time, we will evaluate this process and see how it works for our patients and our care teams. In the near future, we might even consider how automated chat bots might support clinicians in short message-based clinical encounters, where more back and forth could occur.

For now, we will invite our patients and care teams to engage with us in the app, and will look forward to serving our patients in quicker and more convenient ways.