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Health systems drowning in messages from patients are grasping for new ways to manage the deluge — including charging for especially time-consuming responses.

In recent months, health systems including Cleveland Clinic and University of Washington have trotted out new billing policies for when patient portal questions require more than just a few minutes of a provider’s time — an attempt to compensate for staff time spent while also stanching the breakneck response pace patients have come to expect in the consumer world. They’re following a handful of health systems that were early adopters of the practice, including Northwestern and University of California, San Francisco, and have found some success in recouping costs and in some cases, slightly reducing the volume of patient portal messages.

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“We wanted to be able to give patients what they want, which is care that doesn’t have to be scheduled, and is efficient for them both in terms of management and also cost,” said family doctor Crystal Kong-Wong, University of Washington Medicine’s associate chief digital health officer and clinical lead on the health system’s MyChart billing efforts, which began last month. “We are evaluating this, and just because it’s in its current way, shape or form doesn’t mean it has to stay that way.”

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