My nemesis “ mychart”

[nastle]

How do you guys deal with mychart messages ?
how much are you willing to advise via these messages ?
it seems like patients want everything addressed through mychart now

thanks

[abds]

I don’t. My staff answers wound care and other questions that they would otherwise manage over the phone… med refills as another example. If a patient has a question that only I can address they’re told to make an appointment.

[Lordosis]

We don't use that but we have a similar function on our emr. However the vast majority of my messages still come through the phone and my nurse. I rule of thumb is if it is a simple question I can type a one or two line answer so be it. But if it requires more of an explanation or if my simple answer comes up with another question the next step is to schedule an appointment.

[StarTrekDoc]

We actually do quite a bit since we have an access issue. Not only that, we have a relatively high faculty panel too and tend to do care over chart than pulling them off the line. There's a move back to RVU so there's going to be a trend to do less mychart even more and F2F overbook -- inefficient, but that's how they are rewarding care, that's how it's going to go.

[gap55u]

Mychart was marketed as “text your doctor any random question that pops in your head” it feels like. Some docs are absolutely overwhelmed some less so. Inbasket traffic is up 150-200% over the pandemic. We have the option to charge $25 for a more detailed mychart (one with some back and forth) but I would rather just do an off the cuff video visit and charge full visit, or even a virtual check in phone visit, given the wrvu. I also do some one liners/simple stuff for free. And sometimes at a visit, I will queue up a message to send them (Eg reply back when you get this in 3 weeks with your blood pressures)- so that is designed to be easy.

[Random1]

I have all my messages go to the front office staff, if it something clerical or a nurse can't handle. I have the nurse call them back, and if there is anything that can not be taken care of this way, they are offered an appointment either in person or virtual. Patients are told that the email or message goes to the staff, there is no option for the Dr. , it says Dr. X Staff , either front office or nursing.

[Cubicle]

I am still in the archaic days off paper charts. So if a patient calls with a question that requires more than a yes or no, they are scheduled for an office visit. Seen, evaluated, & charted in 10 minutes = 99212.

This keeps the queries down between visits. So then the actual visit is a 99213. I will not when for free if I can help it. The insurances & state already make sure I do enough free work.

[shombra]

same thing

my staff handles 99% of the messages

the answer is almost universally “we will need to see you in the office”

[setsail26]

I love MyChart for getting results to patients, saves my time and staff time. I love it for when I want a patient to send me a brief follow up message. I absolutely hate all the stupid messages patients send. It is at least double what it was before COVID. Our staff just forwards them to the doctor, no one reads them or does anything. It's a terrible system that I have not had much luck in changing it (work for a big system). I really want to make a dot phrase that says "Calm the f down!" to reply to the patients.

[SLC OB]

We are hiring "indirect care" nurses that will manage the inbox via protocols (refills, etc.) to help our physicians. However, having a hard time finding nurses that want to do this work! I absolutely hate MyChart... such a time suck! Only benefits is getting results back quickly but the 5 paragraphs of questions that come back is ridiculous.

[Lordosis]

Also not sure how all your systems work but the patients get the results in real time. So I have messages about the cbc while the cmp is still cooking. Very annoying.

[abds]

I absolutely hate MyChart... such a time suck! Only benefits is getting results back quickly but the 5 paragraphs of questions that come back is ridiculous.

Then why don’t you just not do it? The system takes advantage of our time because the vast majority of us are willing to bend over and take it.

[SLC OB]

Then why don’t you just not do it? The system takes advantage of our time because the vast majority of us are willing to bend over and take it.

It is an expectation of patients and our Health System. One of the disadvantages of highly educated patient population. When I get the 5 paragraphs, I tell my MA to make an appointment. Not dealing with it but unfortunately, I am booked out a ton.

[MaxPower]

My MA or clinic nurse manages all of these. I get maybe 1/100, and then it’s usually just a “what do you want me to do with this” question from my staff that usually ends with me telling them to schedule an appointment. If my clinic staff can’t answer it and it is something that needs my expertise, they can schedule a clinic appointment and pay a copay/office visit charge for my time.

[gap55u]

Also not sure how all your systems work but the patients get the results in real time. So I have messages about the cbc while the cmp is still cooking. Very annoying.

It’s even worse when patients find out about their new major findings via immediate release of results ( HIV, lung mass, unexpected renal failure among such results). I tell all patients that results are released immediately when resulted but I will comment on them— to try to forestall this BS.