Study asks: are e-visits as good as office appointments?

Wed Jan 16, 2013 6:14am IST

Related Topics

REUTERS - "E-visits" to the doctor? According to a U.S. study, they may be just as effective as in-person office visits for uncomplicated ailments such as sinus infections and urinary tract infections - and much cheaper.

For e-visits, patients fill out online forms about their symptoms and a doctor or nurse gets back to them within a few hours with treatment advice.

In the study, which appeared in the journal JAMA Internal Medicine, the main difference between e-visits and office visits was that patients who received their care online were prescribed more antibiotics, a finding that could be concerning but is hard to interpret on its own, the researchers said.

"There are several potential advantages of e-visits, including convenience and efficiency (avoiding travel and time), and lower costs," wrote author Ateev Mehrotra from the RAND Corporation and University of Pittsburgh School of Medicine, and colleagues.

"Furthermore, e-visits can be provided by the patient's primary care physician instead of a physician at an emergency department or urgent care center."

For the study, researchers compared all e-visits and office visits for sinus infections and urinary tract infections (UTIs) at four primary care practices in Pittsburgh, Pennsylvania, between January 2010 and May 2011. Over 90 percent of appointments for both conditions were in-person office visits, out of a total of more than 8,000.

A similar proportion of patients - seven percent or less in each case - had a follow-up visit for the same condition within the next three weeks. That suggests misdiagnosis and treatment failure weren't any higher with e-visits.

However, people with both conditions who had e-visits were more likely to be prescribed antibiotics than those who had in-person appointments. The effect was especially strong with UTIs: 99 percent of those people who had an e-visit received an antibiotic, compared to 49 percent with an office visit.

That could be because doctors are more conservative with treatment when they can't directly examine their patients, the researchers wrote. But it could also be worrisome, given that over-prescription of antibiotics is tied to drug resistance.

"That is something we really need to be careful about and watch for," Mehrotra told Reuters Health.

Even with that difference in prescribing, treating each patient with a UTI cost an average of $74 per e-visit as opposed to $93 for an office visit, based on the researchers' rough estimates.

"All over the country, more and more of these e-visits are taking place," said James Rohrer, a family medicine doctor at the Mayo Clinic in Rochester, Minnesota, who has studied online care.

Insurance companies believe e-visits will save money, he said. For patients, the biggest benefit is convenience.

"If you're not feeling well, getting cleaned up and going into a clinic may not be too attractive," said Rohrer, who was not part of the study. And with e-visits, "there are no parking problems." SOURCE: bit.ly/VYg81Q (Reporting from New York by Genevra Pittman at Reuters Health; editing by Elaine Lies)

FILED UNDER:
Comments (0)
This discussion is now closed. We welcome comments on our articles for a limited period after their publication.

  • Most Popular
  • Most Shared

SCOTLAND VOTES

Reuters Showcase

No Ground War

No Ground War

Obama vows U.S. will not fight another ground war in Iraq.  Full Article 

Beheading Plot

Beheading Plot

Militants urged Australian "demonstration killings" - PM Abbott.  Full Article | Related Story 

Fatal Vaccination

Fatal Vaccination

Measles vaccination campaign halted in northern Syria after 15 children die.  Full Article 

Cancer Detected

Cancer Detected

Toronto Mayor Rob Ford diagnosed with rare cancer.  Full Article 

Ebola Outbreak

Ebola Outbreak

Ebola could drain billions of dollars from African economies - World Bank.  Full Article 

Pakistan Floods

Pakistan Floods

Pakistani Islamists use floods to turn opinion against India  Full Article 

Ukraine Tension

Ukraine Tension

Ukraine PM tells army to be on full battle alert despite ceasefire.  Full Article 

Chemical Weapons

Chemical Weapons

Syria reveals more chemical weapons facilities to watchdog - sources.  Full Article 

Pakistan Protests

Pakistan Protests

Pakistan's PM threatens to clear protesters camped in capital.  Full Article 

Reuters India Mobile

Reuters India Mobile

Get the latest news on the go. Visit Reuters India on your mobile device.  Full Coverage