The news: Researchers from the Mayo Clinic found that patient portal messages decreased after the health system began billing the interactions as e-visits, according to a study recently published in the Annals of Internal Medicine.

Specifically, patient-initiated portal messages fell nearly 9% year-over-year in the six months after systemwide e-visit billing was implemented.

How we got here: Consumers and physicians communicated via patient portals in droves during the pandemic, when in-person appointments were heavily restricted.

But as other aspects of healthcare returned to normal post-pandemic, this patient behavior held steady, leaving already overburdened doctors with another time-consuming responsibility.

• Physicians spent nearly 30 minutes, or about 8%, more time in patient portal MyChart per 8 hours of clinical appointments between 2022 and 2023 than in 2019, per a 2024 UW Health study published in the Annals of Family Medicine.

Our take: Patient portals can help democratize more affordable access to one’s physician, but at the cost of that clinician’s time. Including a billing disclaimer within a patient portal—as the Mayo Clinic did—is intended to deter consumers from abusing that privilege but could discourage them from asking their doctor important questions.

The study’s results also tell us that patients want to be active participants in managing their health. But they don’t want to be nickel-and-dimed for every portal message.

To benefit both providers and patients, a happy medium could be using AI chatbots to help with certain tasks like scheduling reminders and answering general questions.

• An example of just that is Providence’s “Grace” patient navigation AI chatbot, which helps patients manage appointments, find lab and test results, and recommend next steps after asking questions about the user’s symptoms.

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