Marty Player is an associate professor in the College of Medicine, Medical University of South Carolina, in Charleston.
Edward O'Bryan is an assistant professor in the College of Medicine, Medical University of South Carolina.
Health Aff (Millwood). 2018 Dec;37(12):2024-2030. doi: 10.1377/hlthaff.2018.05122.
Asynchronous interactions between patients and providers through patient portals (called e-visits in this article) have the potential to increase access to care and reduce the time requirements for some office visits. We performed a retrospective chart review for nonemergent acute care of adults in the period December 2015-July 2017 at the Medical University of South Carolina. Most patients in the 1,565 e-visits were female (80.2 percent) and ages 18-44 (55.3 percent). Sinus problems (38.1 percent) were the most common complaint. There were some unresolved e-visits (6.4 percent), with patients ages sixty-five and older and those with diarrhea or skin problems having a higher likelihood of their e-visit being unresolved, compared to other groups. The majority (81.5 percent) of in-person follow-ups did not result in diagnosis changes. More than 90 percent of the 665 patients surveyed after an e-visit reported a positive experience. Most patients (92 percent) reported that the e-visit had replaced an in-person visit. Further evaluation of the factors associated with unresolved visits could guide the development of treatment algorithms that could improve the quality of care in, and the cost-effectiveness of, e-visits for acute common conditions.
在 2015 年 12 月至 2017 年 7 月期间,我们对南卡罗来纳医科大学的非紧急急性成人护理进行了回顾性图表审查。在 1565 次电子就诊中,大多数患者为女性(80.2%),年龄在 18-44 岁之间(55.3%)。鼻窦问题(38.1%)是最常见的投诉。有些电子就诊没有得到解决(6.4%),与其他组相比,年龄在 65 岁及以上以及患有腹泻或皮肤问题的患者其电子就诊未得到解决的可能性更高。大多数(81.5%)面对面随访并未导致诊断改变。在电子就诊后接受调查的 665 名患者中,超过 90%的患者报告体验良好。大多数患者(92%)表示电子就诊已经取代了面对面就诊。进一步评估与未解决就诊相关的因素,可以指导制定治疗算法,从而提高电子就诊治疗急性常见疾病的质量和成本效益。