Comparing Advanced Practice Providers and Physicians as Providers of e-Visits

Area of Science:

• Digital Health
• Healthcare Delivery Models
• Advanced Practice Providers

Background:

• Electronic visits (e-visits) are expanding, but research on provider roles and outcomes is limited.
• This study analyzes two e-visit models at UPMC to compare physician and APP providers and outcomes.

Purpose of the Study:

• To compare patient demographics, e-visit volume, response times, diagnoses, and prescribing patterns between physicians and APPs.
• To analyze differences in e-visit outcomes based on provider type and service model.

Main Methods:

• Retrospective analysis of 2,184 e-visits from UPMC AnywhereCare Continuity and Convenience services (Nov 2013-Aug 2014).
• Comparison of patient characteristics, volume, response time, diagnoses, and prescriptions using statistical tests and regression analysis.
• Data sourced from Epic Systems MyChart.

Main Results:

• APPs provided 72.5% of e-visits; their patients were younger, had higher incomes, and were more likely to be unmarried.
• Continuity service users had higher rates of sinusitis; Convenience service users had higher rates of UTI and URI.
• APPs were significantly associated with higher prescribing rates compared to physicians.

Conclusions:

• Demographic differences exist between APP and physician e-visit users.
• E-visit response times are primarily influenced by service policies, not provider type.
• Variations in prescribing quantities between provider types warrant consideration for future e-visit protocols and reimbursement strategies.