Impact of Patient Portal Secure Messages and Electronic Visits on Adult Primary Care Office Visits

North, Frederick; Crane, Sarah J.; Chaudhry, Rajeev; Ebbert, Jon O.; Ytterberg, Karen L.; Tulledge–Scheitel, Sidna M.; Stroebel, Robert J.

doi:10.1089/tmj.2013.0097

Cited by 87 publications

(76 citation statements)

References 13 publications

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“…[1][2][3][4] The current analysis extends these observations by identifying no difference in hospitalizations or ED visits among EM users and nonusers.…”

Section: Discussionsupporting

confidence: 55%

“…However, studies show mixed results, with some reporting increased outpatient visits, [1][2][3] and others showing no effect. 4 Some studies reported that EM is associated with lower HbA1c levels. 2,[5][6][7][8] Thus far, studies regarding EM have not differentiated between type 1 and type 2 diabetes, examined message content, or examined the impact of EM on hospital or emergency department (ED) visits.…”

mentioning

confidence: 99%

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Effect of Electronic Messaging on Glucose Control and Hospital Admissions Among Patients with Diabetes

Petullo

Noble

Dungan

2016

Diabetes Technology & Therapeutics

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Background: Electronic messaging (EM) is increasingly utilized among patients with diabetes, but it is unclear whether it is associated with improved glycemic control, hospital admissions, or emergency visits. Methods: Patients who were seen over a 1 year period at an academic endocrinology clinic with a diagnosis of diabetes were categorized according to portal activation and whether EMs were actually sent. The association between EM and HbA1c and inpatient or emergency department (ED) visits was further characterized using multivariable (MV) linear or logistic regression models. Results: A total of 867 patients were using EM (active user group), 1207 patients had activated the patient portal but did not use the EM function (active nonuser group), and 1542 patients had not activated the patient portal (inactive group). There were important disparities in race, age, income, and other variables across groups. The HbA1c was 7.7% -1.5%, 8.4% -1.9%, and 8.2% -1.8% among the active user, active nonuser, and inactive groups, respectively (P < 0.0001). After controlling for other factors, EM was associated with a 0.25% (SE 0.04%) lower HbA1c compared with the active nonuser group and a 0.19% (SE 0.04%) lower HbA1c compared with the inactive group (P < 0.0001 for both). However, EM frequency was not associated with HbA1c. EM use was not associated with inpatient or ED visits in MV analysis. Conclusions: EM use was associated with improved glycemic control, even after controlling for electronic portal access and other variables, but not with hospitalizations or emergency visits. EM frequency was not associated with glycemic control, justifying the need for prospective studies.

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“…[1][2][3][4] The current analysis extends these observations by identifying no difference in hospitalizations or ED visits among EM users and nonusers.…”

Section: Discussionsupporting

confidence: 55%

mentioning

confidence: 99%

Effect of Electronic Messaging on Glucose Control and Hospital Admissions Among Patients with Diabetes

Petullo

Noble

Dungan

2016

Diabetes Technology & Therapeutics

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“…Enhanced access and continuity are critical enablers of a therapeutic relationship. Practices that focus on these aspects are increasingly making communications available to patients via telephone and a web portal or e-mail, 35 and are working out mechanisms for channeling communications to appropriate staff in care teams. 36,37 The therapeutic relationship is increasingly understood to be central to health and healing and to the patient experience.…”

Section: Direct Care Activitiesmentioning

confidence: 99%

Achieving Value in Primary Care: The Primary Care Value Model

Rollow

Cucchiara

2016

Ann Fam Med

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The patient-centered medical home (PCMH) model provides a compelling vision for primary care transformation, but studies of its impact have used insufficiently patient-centered metrics with inconsistent results. We propose a framework for defining patient-centered value and a new model for value-based primary care transformation: the primary care value model (PCVM). We advocate for use of patient-centered value when measuring the impact of primary care transformation, recognition, and performance-based payment; for financial support and research and development to better define primary care value-creating activities and their implementation; and for use of the model to support primary care organizations in transformation.

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“…Others have found that patient access to health records and messaging through Internet portals was not associated with an increase in primary care utilization. 4,5 Portal tracking data make it possible to determine whether specific uses of the patient Internet portals could lead to greater health care utilization. We hypothesized that logging into the portal to view sections of the medical record regardless of whether office visit notes are viewable, and/or to message with providers about clinical issues would not lead to increased ambulatory care utilization.…”

mentioning

confidence: 99%

Do Patients Who Access Clinical Information on Patient Internet Portals Have More Primary Care Visits?

et al. 2016

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Impact of Patient Portal Secure Messages and Electronic Visits on Adult Primary Care Office Visits

Abstract: No significant change in face-to-face visit frequency was observed following implementation of portal messaging. Secure messaging and e-visits through a patient portal may not result in a change of adult primary care face-to-face visits.

Cited by 87 publications

References 13 publications

Effect of Electronic Messaging on Glucose Control and Hospital Admissions Among Patients with Diabetes

Effect of Electronic Messaging on Glucose Control and Hospital Admissions Among Patients with Diabetes

Achieving Value in Primary Care: The Primary Care Value Model

Do Patients Who Access Clinical Information on Patient Internet Portals Have More Primary Care Visits?

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