Patients favor asynchronous e-visits for common conditions

Asynchronous electronic visits are popular for common outpatient conditions and rarely result in follow-up visits for the same diagnosis within seven days, according to new research.

Published in JAMA Network Open, the study examined the utilization of asynchronous electronic visits (e-visits), a type of asynchronous telehealth where communication between patients and providers does not occur in real time.

At Kaiser Permanente, where the study was conducted, e-visits are defined as "structured online interactions for prespecified conditions in which patients are asked closed-ended questions in a predetermined sequence to gather information related to the chief concern and potential diagnosis." Algorithms that power the e-visits determine if a patient requires in-person care or can continue with virtual care. In the latter case, physicians use the information gathered by the system to diagnose the patient and provide them with a care plan via a message.

For the study, researchers examined initial outpatient visits between Jan. 1 and Dec. 31, 2024, for four conditions: urinary tract infections (UTIs), seasonal allergies, acne and international travel advice.

The study sample included 73,560 total initial visits, of which 34,895 were e-visits, 20,647 were audio-only telehealth visits, 3,135 were synchronous video visits and 14,883 were in-person office visits.

Researchers found that e-visits comprised 58% of total initial visits for UTIs, 56% for international travel advice, 24% for acne and 24% for seasonal allergies.

They also found that e-visits were used for more than 50% of UTI care visits by nearly all patient subgroups, except patients aged 65 and older, who were non-English speakers or who had the highest comorbidity scores.

In general, e-visit use was more common among slightly older adults. E-visit use for acne was least likely among those aged 18-29 years compared to those in older age groups. Similarly, e-visit use for seasonal allergy was most likely among those in the 30-39 age group. For international travel advice, e-visits were most likely among adults aged 30-39 years and 40-49 years compared to those aged 18-29 years.

Further, follow-up visits for the same diagnosis within seven days after initial e-visits were not common. The adjusted percentages of follow-up visits were 2.48% for UTI, 2.11% for acne, 6.45% for seasonal allergies and 0.12% for international travel advice.

"E-visits may be a useful mode of providing highly convenient access for patients and helping clinicians deliver care for common conditions," the researchers concluded.