Who are portal users vs. early e-Visit adopters? A preliminary analysis

Patient portals and eVisits are gaining momentum due to increasing consumer demand for improved access to clinical information and services, availability of new technologies to deploy them and development of reimbursement initiatives by major payers. Despite increasing interest in online health consultation by consumers, adoption has been slow and little is known about the users of such services. In this study, we analyze the key features that distinguish early adopters of eVisits from portal consumers, in aggregate and in four distinct ambulatory practices, using data from a major healthcare provider in Western Pennsylvania. Preliminary results indicate that out of 10,532 portal users, the 336 patients who submitted 446 eVisits between April 1, 2009 and May 31, 2010 are younger on average, predominantly female, not retired, but in poorer health condition. They access the portal more frequently, indicating that they are potentially more involved in managing their health. Using fixed-effects logistic regression models to compare across practices, we note that practice indicator is a significant predictor of eVisit usage, perhaps due to the varying strategies used to build awareness and encourage adoption. Despite the small difference in out-of-pocket payment for eVisits covered by insurance vs. otherwise, insurance coverage for eVisits significantly contributes to increased usage. In ongoing work, additional characteristics of patients and practices that have access to the patient portal will be used to better delineate patients' choice of eVisit vs. the traditional office visit.