title: Internet-based medical visit and diagnosis for common medical problems: experience of first user cohort.
abstract: OBJECTIVE
  Internet-based medical visits, or "structured e-Visits," allow patients to report symptoms and seek diagnosis and treatment from their doctor over a secure Web site, without calling or visiting the physician's office. While acceptability of e-Visits has been investigated, outcomes associated with e-Visits, that is, whether patients receiving diagnoses receive appropriate care or need to return to the doctor, remain unexplored.
  
  
  METHODS
  The first 156 e-Visit users from a large family medicine practice were surveyed regarding their experience with the e-Visit and e-Visit outcomes. In addition, medical records for patients making e-Visits were reviewed to examine need for follow-up care within 7 days.
  
  
  RESULTS
  Interviews were completed with 121 patients (77.6% participation). The most common type of e-Visit was for "other" symptoms or concerns (37%), followed by sinus/cold symptoms (35%). Back pain, urinary symptoms, cough, diarrhea, conjunctivitis, and vaginal irritation were each less frequent (<10%). A majority, 61% completed e-Visits with their own physician. The majority of patients (57.0%) reported receipt of a diagnosis without need for follow-up beyond a prescription; 75% of patients thought the e-Visit was as good as or better than an in-person visit, and only 11.6% felt that their concerns or questions were incompletely addressed. In a review of medical records, 16.9% had a follow-up visit within 7 days, mostly for the same condition. Four of these were on the same day as the e-Visit, including one emergency department visit.
  
  
  CONCLUSIONS
  Outcomes for the e-Visit suggest that it is an appropriate and potentially cost-saving addition to in-person delivery of primary care.
authors: Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania 15261, USA. smalbert@pitt.edu
authors: Steven M
authors: SM
authors: Albert
authors: Grant J
authors: GJ
authors: Shevchik
authors: Suzanne
authors: S
authors: Paone
authors: G Daniel
authors: GD
authors: Martich
mesh_terms: D022126:Access to Information; D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D017046:Cost Savings; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D033181:Information Dissemination / Q000379:methods*; D020407:Internet / Q000458:organization & administration*; D008297:Male; D008875:Middle Aged; D010414:Pennsylvania; D010817:Physician-Patient Relations; D012111:Residence Characteristics; D011795:Surveys and Questionnaires; D017216:Telemedicine / Q000458:organization & administration*; D055815:Young Adult