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Oral Presentation

(DTC8-01) Electronic Visits for Common Acute Conditions: Evaluation of a New Program

Monday, April 24
2:45 PM - 3:04 PM
Location: W224 CD

Objectives
1. Identify the most frequent electronic visit (e-visit) requests made to a new program implemented at an academic medical center
2. Analyze the care provided via e-visits.
3. Describe the patient experience associated with e-visits.


Methods
This is a retrospective chart review of 294 patients (> 18 years old) at an academic medical center receiving care via e-visits, which provide asynchronous electronic interactions between patients and providers through a patient portal. Patients request e-visits for common acute conditions (eg heartburn, diarrhea, influenza, rash, red eye, sinus problems, urinary problems, vaginal discharge). Patients were also sent a survey electronically regarding their experience with e-visits which assessed ease of use and the care provided. The study was conducted from December 2015 to July 2016.

Outcome Measurements: Most common conditions requested, medications provided, timeliness of replies and when requests were made was assessed. Follow-up contact after e-visits was also evaluated for two weeks after the e-visit. Self-reported patient experience measures were also assessed. Descriptive statistics and Chi-square tests evaluating the provision of antibiotics stratified by the type of e-visit and when the e-visit was provided were calculated using SPSS.


Results
Most e-visits were done by women (83%) and those over 40 years old (66%). Sinus problems (35%) and urinary problems (23%) were the most frequently requested. Most requests were made between 9-5 pm (65%), and were answered within 2 hours (86%). Most visits included a prescription for antibiotics (76%), with azithromycin (29%) being the most prescribed. Antibiotics were most commonly prescribed for sinus and urinary problems (p < 0.05) versus other diagnoses, but there was no difference in prescription based on when the e-visit was requested (p=0.19). Most visits did not require any follow up (83%). Surveys were obtained for 78 patients, and showed a majority thought e-visits were easy to complete (98.7%) and the provider was able to address their problem (96%). Most would recommend e-visits to others (96%). If e-visits were not available, most patients would have sought care from their doctor’s office (54%) or an urgent care/emergency department (41%).

Conclusion
E-visits were easy to use and usually addressed the patient’s condition without in-person interaction. Most patients did not require further care within 2 weeks, which supports that their condition was adequately addressed. Most patients had other options for receiving care, but chose to use e-visits. The most commonly requested e-visits were for conditions that often receive antibiotics, and antibiotics were commonly provided through e-visits. Further research is needed to further evaluate the quality of care provided within e-visits, and specifically whether antibiotics are prescribed appropriately.

Marty Player

Associate Professor
Medical University of South Carolina

Marty Player MD, MS
Marty Player received his Bachelors of Science from the South Carolina Honors College at USC and Medical Degree from the University of South Carolina. He completed a residency and a chief resident year in Family Medicine at Christiana Care Hospital in Wilmington Delaware in 2005. He subsequently completed a 2-year faculty development fellowship and Masters in Clinical Research (MSCR) at the Medical University of South Carolina in Charleston (2005-2007). He has been faculty in the Department of Family Medicine since 2007 and was promoted to Associate Professor in 2016. He is working on the development, implementation and evaluation of electronic visits and video visits within primary care settings.

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Jessica D. Bright

Stats and Research Analysis
Medical University of South Carolina

Jessica Bright BS
Jessica Bright received her Bachelors of Science from Clemson University. She joined the Department of Family Medicine in February 2016. She is currently working towards a Master of Health Informatics from the Medical University of South Carolina (MUSC). Her interest includes telehealth, population health and the utilization of informatics to improve the quality of care.

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Vanessa Diaz

Director of Clinical Services
Medical University of South Carolina

Dr. Diaz received a Bachelor of Science and Medical Degree from the University of Miami, then completed residency at Memorial Hospital in Savannah, Georgia. She subsequently received an MSCR from the Medical University of South Carolina (MUSC) during a two year academic fellowship with the Department of Family Medicine from 2002-2004. She then joined the faculty in the Department of Family Medicine at MUSC, where she has served as Director of Clinical Services since 2011 and is a tenured Professor. Her interests include telehealth, health disparities and faculty development. Dr. Diaz is originally from Panama and is fluent in Spanish.

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(DTC8-01) Electronic Visits for Common Acute Conditions: Evaluation of a New Program



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