The impact of e-visits on patient access to primary care

Xiang Zhong (), Peter Hoonakker (), Philip A. Bain (), Albert J. Musa () and Jingshan Li ()
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Xiang Zhong: University of Florida
Peter Hoonakker: University of Wisconsin
Philip A. Bain: Dean Health System
Albert J. Musa: Dean Health System
Jingshan Li: University of Wisconsin

Health Care Management Science, 2018, vol. 21, issue 4, No 2, 475-491

Abstract: Abstract To improve patient access to primary care, many healthcare organizations have introduced electronic visits (e-visits) to provide patient-physician communication through secure messages. However, it remains unclear how e-visit affects physicians’ operations on a daily basis and whether it would increase physicians’ panel size. In this study, we consider a primary care physician who has a steady patient panel and manages patients’ office and e-visits, as well as other indirect care tasks. We use queueing-based performance outcomes to evaluate the performance of care delivery. The results suggest that improved operational efficiency is achieved only when the service time of e-visits is smaller enough to compensate the effectiveness loss due to online communications. A simple approximation formula of the relationship between e-visit service time and e-visit to office visit referral ratio is provided serving as a guideline for evaluating the performance of e-visit implementation. Furthermore, based on the analysis of the impact of e-visits on physician’s capacity, we conclude that it is not the more e-visits the better, and the condition for maximal panel size is investigated. Finally, the expected outcomes of implementing e-visits at Dean East Clinic are discussed.

Keywords: Primary care; E-visits; Queueing; Cycle time; Patient access; Panel size (search for similar items in EconPapers)
Date: 2018
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Citations: View citations in EconPapers (4)

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DOI: 10.1007/s10729-017-9404-8

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