Patient Perceptions of e-Visits: Qualitative Study of Older Adults to Inform Health System Implementation

Differences in use of telemedicine integrated into traditional primary health care - a comparative observational study

Telemedicine in primary health care is expected to address many of the issues currently challenging service delivery. However, the impact and effect will depend on who will use the new technology.

OBJECTIVE

The objective of the study was to investigate differences between users and non-users of telemedicine integrated into traditional office-based primary health care.

METHODS

Quantitative registry-based population study in two regions in the southeast part of Sweden (n = 73,486), comparing users with non-users of telemedicine across the variables sex, age, socioeconomic status (SES), morbidity and health care seeking behaviour (HSB). Two study periods of six months were used (September 2019-February 2020 for Region Östergötland, and September 2021-February 2022 for Region Kalmar County) to collect user data. A reference period of 36 months (September 2016-August 2019) was used, to collect data on HSB.

RESULTS

Users were more often women under the age of 60 and had higher morbidity (measured as resource utilisation) than non-users (p < .001). In contrast, no statistically significant differences were seen between the two groups regarding SES, measured as Care Need Index (CNI). Regarding HSB, a proxy measure (health record entries) showed more entries for users than non-users.

CONCLUSIONS

Our findings suggest that users are more likely to be women and below the age of 60. Likewise, users also tend to have a greater need for health care services compared to non-users, and they seek health care more often compared to non-users. No differences regarding SES were found.

Non-Face-to-Face Services in Neurologic Care

Neurologists in ambulatory settings struggle with low appointment availability and increased work related to patient care outside of clinic visits. Neurologists can better meet these demands using asynchronous or non-face-to-face care options. Specific billing codes allow reimbursement for work neurologists are already doing to care for their patients between visits. This includes care delivery over patient portal messages (e-visits), asynchronous consultations through the electronic health record (EHR) system requested by providers for their patients with neurologic issues (eConsults), care coordination and record review outside of clinic visits (prolonged service for non-face-to-face care outside of the date of service and transitional care management), and analyzing data from new technologies and devices for patient diagnosis and therapeutic monitoring (remote patient monitoring). Artificial intelligence shows promise to improve how neurologists deliver asynchronous care. More seamless incorporation of asynchronous care options in the EHR and clinic templates will ultimately be necessary to improve neurologists' efficiency and work-life balance.

Changes in Secure Messaging After Implementation of Billing E-Visits by Demographic Group

This cohort study investigates the association of demographic characteristics with changes in patient portal messaging after implementation of e-visit billing.

National Trends in Billing Secure Messages as E-Visits

This study assesses US trends in e-visit billing using national all-payer claims.