Uptake and patient and provider communication modality preferences of virtual visits in primary care: a retrospective cohort study in Canada

Abstract

<jats:sec><jats:title>Objectives</jats:title><jats:p>To evaluate the uptake of a platform for virtual visits in primary care, examine patient and physician preferences for virtual communication methods and report on characteristics of visits and patients experience of care.</jats:p></jats:sec><jats:sec><jats:title>Design</jats:title><jats:p>A retrospective cohort study.</jats:p></jats:sec><jats:sec><jats:title>Setting</jats:title><jats:p>Primary care practices within five regions in Ontario, Canada after 18 months of access to virtual care services.</jats:p></jats:sec><jats:sec><jats:title>Participants</jats:title><jats:p>326 primary care providers and 14 291 registered patients.</jats:p></jats:sec><jats:sec><jats:title>Interventions</jats:title><jats:p>Providers used a platform that allowed them to connect with their patients through synchronous (audio/video) and/or asynchronous (secure messaging) communication.</jats:p></jats:sec><jats:sec><jats:title>Main outcome measures</jats:title><jats:p>User-level data from the platforms including patient demographics, practice characteristics, communication modality used, visit characteristics and patients’ satisfaction.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Among the participants, 44% of registered patients and 60% of registered providers used the platform at least once. Among patient users, 51% completed at least one virtual visit. The majority of virtual visits (94%) involved secure messaging. The most common patient requests were for medication prescriptions (24%) and follow-up from previous appointment (22%). The most common provider request was to follow-up on test results (59%). Providers indicated that 81% of virtual visits required no follow-up for that issue and 99% of patients reported that they would use virtual care services again.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>While there are a growing number of primary care video visit services, our study found that both patients and providers in rostered practices prefer secure messaging over video. Despite fears that virtual visits would be overused by patients, when patients connected with their own primary care provider, many virtual visits appeared to replace in-person visits, and patients did not overwhelm physicians with requests. This approach may improve access and continuity in primary care.</jats:p></jats:sec>

Virtual care use before and during the COVID-19 pandemic: a repeated cross-sectional study

“…Potential advantages of telephone over video visits include no requirement for broadband (particularly in rural and northern parts of the province) and ability to scale quickly. 20 The observed higher use of telephone visits over video visits is in keeping with the literature, 2 , 21 and, in health care systems that rely on large virtual care programs, telephone calls and asynchronous messaging still represent the bulk of the virtual care provided. 22 …”

“…Virtual care, commonly defined as medical care delivered at a distance by means of technology, has existed since the 1970s. 1 Despite substantial interest and investment in virtual care by both the federal and provincial governments, 2 – 4 widespread adoption was modest. 5 , 6 Research suggested that barriers to virtual care uptake in Ontario before the pandemic included limited physician reimbursement and government mandates that virtual visits use an approved video platform.…”

Using antibiotics wisely for respiratory tract infection in the era of covid-19

“…1 however, they may limit proper assessment and diagnosis. 11 Most RTI syndromes are viral and can still be diagnosed and managed using virtual care. Conversely, bacterial RTI infections, which are the exception, generally require an in-person assessment to make an accurate diagnosis.…”

Developments in healthcare information systems in Ireland and internationally

“…In addition, the form that telemedicine takes is important. Recent research has found that, for many patients, secure messaging from clinicians is favoured over video consultations (Stamenova et al, 2020).…”