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Electronic Visit Use and Resolution Rates for Adult Outpatient Conditions in an Integrated Care Setting.

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Asynchronous electronic visits (e-visits) are popular for common conditions like UTIs and allergies, with low follow-up rates. E-visits offer convenient outpatient care, though some patient groups may require more follow-up.

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Area of Science:

  • Digital health
  • Outpatient care delivery
  • Health services research

Background:

  • Asynchronous electronic visits (e-visits) are emerging as a convenient outpatient care modality.
  • Limited data exists on e-visit utilization and patient outcomes.

Purpose of the Study:

  • Compare e-visit usage against telephone, video, and in-person visits for four common outpatient conditions.
  • Evaluate the rates of follow-up visits within seven days across different visit types.
  • Identify patient characteristics associated with e-visit and subsequent follow-up visit utilization.

Main Methods:

  • Cross-sectional analysis of outpatient visits in Kaiser Permanente Northern California (4.6 million patients).
  • Study included adults aged 18+ with initial visits for urinary tract infection (UTI), seasonal allergies, acne, or international travel advice in 2024.
  • Utilized electronic health record data; follow-up visit rates analyzed using modified Poisson regression.

Main Results:

  • E-visits constituted a significant portion of initial visits: 58% for UTI, 24% for allergies, 24% for acne, and 56% for travel advice.
  • Follow-up visits within seven days were uncommon after e-visits (UTI: 2.48%, allergies: 6.45%, acne: 2.11%, travel: 0.12%).
  • E-visit follow-up rates were lower than other modalities for UTI, higher for allergies, and similar for acne and travel. Older adults and certain minority groups had higher UTI e-visit follow-up risks.

Conclusions:

  • Asynchronous e-visits are frequently chosen by patients for common outpatient conditions when available.
  • Both e-visits and traditional visit types demonstrate high resolution rates without the need for short-term follow-up.
  • E-visits represent an effective component of modern outpatient care delivery.