data, we don’t observe any video interactions. I think those are very exciting and definitely the next step [after] this study.
X: If you go back in time, say, a decade ago, when many health systems were installing new EHR software and introducing patient portals for the first time, do you think the belief at the time was that patient portals would free up doctors’ time and make their jobs easier?
HB: I think that was the premise. [Some reports estimated health systems could] expect to save millions of dollars in terms of fewer office visits, doctors being able to handle more patients, and similar things. So I think that was definitely one of the goals and expectations.
X: One of the key (and to some, surprising) findings in this study was that as the number of e-visits increased, so did the number of office visits, reducing doctors’ capacity to take on new patients. And you all didn’t observe any additional health benefits to patients following the increase in e-visits. Do you think those findings might lead physicians and health systems to rethink their use of patient portals?
HB: I really hope so. The goal of our study was to basically paint a picture: what is happening? We advertise these [portals]. Many people champion these in the health system, to be using these more and more. What we show is that they don’t seem to be doing some of the things that we were expecting, in terms of improving patient health.
I think the best thing that can come out of this study is more research into figuring out how to incorporate e-visits in healthcare, to achieve the real goals: reducing costs, improving care quality, and improving the work of doctors. We need more research into seeing how we can leverage technology to improve patient health, reduce costs, and improve the doctor’s life. Just throwing technology at something doesn’t necessarily help.
X: What about the companies that develop electronic health records software, like Athenahealth (NASDAQ: [[ticker:ATHN]]), Cerner (NASDAQ: [[ticker:CERN]]), and Epic Systems? Do you think they ought to rethink the design of their patient portals?
HB: I think that’s highly possible. In the long run, [records software like] Epic is going to be the operating system of hospitals—the Microsoft (NASDAQ: [[ticker:MSFT]]) of a hospital.
Microsoft was designing its operating systems: Windows 95, Windows 98. Over time, it learned from Apple (NASDAQ: [[ticker:AAPL]]). It learned from Linux. [Microsoft] basically found the nice features in all of them and started incorporating it into Windows.
It’s quite possible you’ll see a similar pattern from Epic. Epic is observing all these companies that are experimenting with different forms of e-visits. I think it’s entirely possible that Epic [may be in a position to] re-design e-visits as this unfolds, as health systems and Epic itself learns more about how to make these efficient.
X: What type of feedback have you and your co-authors received following the study’s publication?
HB: We have been in constant touch with the health system that we have been working with. They have been very excited to know more [about] what’s going on. They are providing us with more recent data to do more research on the topic.
A few startups e-mailed me [asking], “What about video?” “What about payments?” I think that’s exactly the goal. I wanted this research to start a conversation and try to
