Characteristics of Physicians Who Adopted Medicare's New Advance Care Planning Codes in the First Year

Smartphone Application Allowing Physicians to Call Patients Associated with Increased Physician Productivity

BACKGROUND

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.

OBJECTIVE

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.

MAIN MEASURES

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.

KEY RESULTS

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).

CONCLUSIONS

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.