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

Area of Science:

• Digital Health
• Health Services Research
• Geriatric Medicine

Background:

• Electronic visits (e-visits) are billable, asynchronous patient-initiated messages requiring provider medical decision-making.
• Unequal use of e-visits may exacerbate health disparities.
• Qualitative assessment of older adults' perceptions of e-visits is lacking.

Purpose of the Study:

• To explore patient perceptions of e-visits.
• To identify perceived utility and barriers to e-visit use.
• To understand implications for care, focusing on vulnerable populations.

Main Methods:

• Qualitative study utilizing in-depth structured individual interviews.
• Interviews assessed knowledge and perceptions of e-visits versus other communication methods.
• Content analysis was used to analyze interview data.

Main Results:

• Twenty interviews were conducted with adults over 65.
• Participants were generally accepting of e-visits but preferred synchronous communication (nearly two-thirds).
• Concerns included the "e-visit" name, appropriate use cases, and technology access; financial barriers were uncommon.

Conclusions:

• Older adults are receptive to e-visits but may favor synchronous communication.
• Implementation strategies should address communication preferences and technology comfort.
• Opportunities exist to enhance e-visit adoption and equitable access.