Asynchronous virtual visits for the follow-up of chronic conditions.
BACKGROUND
Both primary care and specialty care in many areas face access constraints. Tools to evaluate and engage patients with chronic disease, without having them present to the clinic, are needed. Asynchronous virtual care has been explored as one of the ways to deliver care more efficiently, yet this has not been integrated into a busy practice environment. This pilot study aims to assess the utility of a Web platform that allows patients with chronic disease to be evaluated for follow-up care, thereby avoiding an office visit.


METHODS
Patients with 10 common chronic conditions were recruited into the study at a busy primary care clinic. Instead of booking an in-office follow-up visit, they were directed online to complete a questionnaire pertaining to their condition 7-28 days after their office visit. Their physician would review their responses and make treatment decisions, informing the patient online. Patient and physician satisfaction was measured using a validated Likert scale after each visit.


RESULTS
Patients were satisfied with the Web site and process as a way to receive their follow-up care. Clinicians were satisfied in making clinical decisions with the information received via the Web site. The clinician time spent for the overall encounter was significantly shorter than for an in-person follow-up visit.


CONCLUSIONS
Clinicians and patients are interested in tools that improve patient health, are convenient, and save time for both parties. Targeting patients with chronic illness and leveraging available technology to deliver the care are very satisfactory to both clinicians and patients. Asynchronous virtual visits for patients with chronic medical conditions are an effective way to evaluate and manage patients, while providing physicians significant time savings. These visits have the potential to reduce in-office follow-up visits across primary care, potentially improving access and reducing costs.
1 Massachusetts General Hospital-Beacon Hill Primary Care , Boston, Massachusetts.
Ronald F
RF
Dixon
Latha
L
Rao
D000328:Adult; D000553:Ambulatory Care / Q000379:methods; D002908:Chronic Disease / Q000628:therapy*; D003266:Continuity of Patient Care; D017046:Cost Savings; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020407:Internet / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000379:methods; D018570:Risk Assessment; D017216:Telemedicine / Q000191:economics / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States; D049269:Videoconferencing
e-health; technology; telehealth; telemedicine