OBJECTIVE
To study the use of e-visits in a primary care setting.
PATIENTS AND METHODS
A pilot study of using the Internet for online care (“e-visits”) was conducted in
the Department of Family Medicine at Mayo Clinic in Rochester, MN. Patients in the
department preregistered for the service, and then were able to use the online portal
for consultations with their primary care physician. Use of the online portal was
monitored and data were collected from November 1, 2007, through October 31, 2009.
RESULTS
During the 2-year period, 4282 patients were registered for the service. Patients
made 2531 online visits, and billings were made for 1159 patients. E-visits were submitted
primarily by women during working hours and involved 294 different conditions. Of
the 2531 e-visits, 62 (2%) included uploaded photographs, and 411 (16%) replaced nonbillable
telephone protocols with billable encounters. The e-visits made office visits unnecessary
in 1012 cases (40%); in 324 cases (13%), the patient was asked to schedule an appointment
for a face-to-face encounter.
CONCLUSION
Although limited in scope, to our knowledge this is the largest study of online visits
in primary care using a structured history, allowing the patient to enter any problem,
and billing the patient when appropriate. The extent of conditions possible for treatment
by online care was far-ranging and was managed with a minimum of message exchanges
by using structured histories. Processes previously given as a free service or by
nurse triage and subject to malpractice (protocols) were now documented and billed.
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- Patient-Computer Dialogue: A Hope for the FutureMayo Clinic ProceedingsVol. 85Issue 8
- PreviewDialogue between physician and patient continues to be the mainstay of clinical medicine. During the clinical visit, the physician endeavors to establish rapport, develop bonds of mutual respect and trust, obtain information relevant to the patient's medical problems and general health, and communicate information for the patient's immediate and long-range use. In turn, the patient can communicate personal preferences to the physician, and the two can work together to develop an approach to treatment that is consistent with both the patient's wishes and the dictates of medical science.
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