RAND Corporation, 1776 Main Street, Santa Monica, CA, 90401, USA.
RAND Corporation, Boston, MA, USA.
J Gen Intern Med. 2021 Aug;36(8):2307-2314. doi: 10.1007/s11606-021-06663-2. Epub 2021 Mar 5.
Telehealth and other technologies that enable remote patient-physician communication technologies have widespread use among physicians and other health care providers, but the impacts of these technologies on physician productivity are not well known.
To determine whether a HIPAA-compliant application that allows physicians to call patients from their personal cell phones is associated with an increase in physician productivity.
DESIGN, SETTING, AND PARTICIPANTS: We used a 100% sample of Medicare claims and longitudinal physician-level data to examine whether physician use of a smartphone application that enables physician-patient phone calls is associated with changes in Medicare patient volume and services. We compared early adopters of the application, 31,577 physicians providing Part B services who initiated use of the application between January 2014 and December 2017, with later adopters, 22,988 physicians who initiated use between January 2018 and July 2019.
Physician productivity was measured as total Medicare Part B beneficiaries, total Part B services provided, the number of Part B beneficiaries with any evaluation and management (E&M) service, the total number of E&M services provided, and the average number of E&M services provided per beneficiary.
Following application use, there was a 0.52 increase (95% CI: 0.19 to 0.85) in the monthly number of Part B beneficiaries seen. This difference translates to a 0.8% increase in Part B beneficiaries. Similar increases were observed for the number of unique beneficiaries for which the physician provided E&M services-a 0.50 increase (95% CI: 0.27 to 0.73) or 1.2%. There was a 0.43 increase (95% CI: 0.07 to 0.78) in monthly E&M services (0.7% increase).
Physicians who used a freely available smartphone application modestly increased their total Medicare beneficiary volume and total number of E&M services provided, suggesting potential improvements in physician productivity.
远程医患通信技术（如远程医疗和其他技术）在医生和其他医疗保健提供者中得到了广泛应用，但这些技术对医生生产力的影响尚不清楚。
确定是否一种符合 HIPAA 标准的应用程序，允许医生通过个人手机给患者打电话，与医生的生产力提高有关。
设计、设置和参与者：我们使用了 100%的医疗保险索赔和纵向医生水平数据，以检查使用智能手机应用程序进行医患电话通话的医生是否与医疗保险患者数量和服务的变化有关。我们将应用程序的早期采用者（2014 年 1 月至 2017 年 12 月期间开始使用该应用程序的 31577 名提供 B 部分服务的医生）与后来的采用者（2018 年 1 月至 2019 年 7 月期间开始使用该应用程序的 22988 名医生）进行了比较。
医生的生产力以医疗保险 B 部分的全部受益人、提供的 B 部分服务总数、接受任何评估和管理 (E&M) 服务的 B 部分受益人的数量、提供的 E&M 服务总数以及每位受益人的平均 E&M 服务数量来衡量。
在使用该应用程序后，每月就诊的 B 部分受益人数量增加了 0.52（95%置信区间：0.19 至 0.85）。这一差异意味着 B 部分受益人的比例增加了 0.8%。类似的增加也出现在接受医生提供 E&M 服务的独特受益人的数量上，增加了 0.50（95%置信区间：0.27 至 0.73）或 1.2%。每月 E&M 服务增加了 0.43（95%置信区间：0.07 至 0.78）（增加 0.7%）。
使用免费智能手机应用程序的医生适度增加了他们的医疗保险总受益人数和提供的 E&M 服务总数，这表明医生的生产力可能有所提高。
