title: Online medical care: the current state of "eVisits" in acute primary care delivery.
abstract: BACKGROUND
  Online technologies offer the promise of an efficient, improved healthcare system. Patients benefit from increased access to care, physicians are afforded greater flexibility in care delivery, and the health system itself benefits from lower costs to provide such care. One method of incorporating online care into clinical practice, called electronic office visits or "eVisits," allows physicians to provide a consultation with patients online. We performed an analysis of the current published literature on eVisits as well as present emerging research describing the use of mobile platforms as the delivery model. We focused on the role of eVisits in acute primary care practice.
  
  
  METHODS
  A literature review was conducted using electronic databases with a variety of search terms related to the use of eVisits in primary care.
  
  
  RESULTS
  Several advantages to eVisit utilization in the primary care setting were identified, namely, improvements in efficiency, continuity of care, quality of care, and access to care. Barriers to eVisit implementation were also identified, including challenges with incorporation into workflow, reimbursement, physician technological literacy, patient health literacy, overuse, security, confidentiality, and integration with existing medical technologies.
  
  
  CONCLUSIONS
  Only one study of patient satisfaction with eVisit acute primary care services was identified, and this suggests that previous analyses of eVisit utilization are lacking this key component of healthcare service delivery evaluations. The delivery of primary care via eVisits on mobile platforms is still in adolescence, with few methodologically rigorous analyses of outcomes of efficiency, patient health, and satisfaction.
authors.affiliation: 1 College of Pharmacy, University of Kentucky , Lexington, Kentucky.
authors.forename: Ryan
authors.initials: R
authors.lastname: Hickson
authors.forename: Jeffery
authors.initials: J
authors.lastname: Talbert
authors.forename: William C
authors.initials: WC
authors.lastname: Thornbury
authors.forename: Nathan R
authors.initials: NR
authors.lastname: Perin
authors.forename: Amie J
authors.initials: AJ
authors.lastname: Goodin
mesh_terms: D000208:Acute Disease; D001291:Attitude of Health Personnel; D003142:Communication; D003219:Confidentiality; D006297:Health Services Accessibility / Q000191:economics / Q000639:trends*; D006801:Humans; D020407:Internet; D063731:Mobile Applications / Q000191:economics / Q000639:trends*; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D011320:Primary Health Care / Q000191:economics / Q000379:methods / Q000639:trends*; D017216:Telemedicine / Q000191:economics / Q000379:methods / Q000639:trends*
keywords: e-health; information management; mobile health; telecommunications