Physician-patient e-visit programs - Implementation and appropriateness

Telemedicine and e-health includes the delivery of healthcare over a distance through the use of telecommunication technologies. One specific application is the use of 'e-visits' within a clinical setting. e-Visits refer to any type of online patient-provider consultation where electronic information is exchanged, particularly involving the transmission via secure servers. Among many others, services such as patient portals and patient-provider e-mail systems fall into this category. Research has shown that patients have a great desire for the ability to communicate with their providers electronically. Despite consumer demand, provider adoption of e-visit technologies has been slow. Though there are many applications currently being piloted across the US, universal diffusion of e-visit technology has not been reached. Reasons for provider hesitation to adopt e-visit technologies include fears of being overburdened by electronic communication, improper use of electronic communication by patients, lack of reimbursement schemes, legal and regulatory issues, and concerns over security, privacy, and confidentiality. Further research is needed to evaluate and document a wide range of key issues regarding e-visits; evidence concerning the impacts on clinical outcomes, access to healthcare, organizational issues, and financial aspects will all be necessary to guide decision making. While it is imperative that research regarding e-visits assesses the impact on providers and patients (at a micro level), it is also essential that it assesses the organizational issues (at a macro level) that are affected by these technologies. Finally, future research should also attempt to more fully understand the financial impacts that e-visit technologies currently have and potentially could have on the healthcare industry. Market forces have historically shown the ability to alter industry structures over time, as demand and need for services increases. As a result, consumers may ultimately drive demand for e-visit services in ways providers will be required to adopt.