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A Comparison of Care at E-visits and Physician Office Visits for Sinusitis and Urinary Tract Infection
Open accessAbstract
Internet capabilities create the opportunity for eVisits, in which physicians and patients interact virtually instead of face-to-face. In an eVisit, a patient logs into her secure personal health record internet portal and answers a series of questions about her condition. This written information is sent to the physician, who makes a diagnosis, orders necessary care, puts a note in the patient’s electronic medical record (EMR), and replies to the patient via the secure portal within several hours. eVisits are offered by numerous health systems and are commonly reimbursed by health plans.1,2 eVisits typically focus on care for acute conditions, such as minor infections. There are several potential advantages of eVisits, including convenience and efficiency (avoiding travel and time) and lower costs.3 Further, eVisits can be provided by the patient’s primary care physician (PCP) instead of a physician at an emergency department or urgent care center. The main concerns about eVisits center on quality issues: whether physicians can make accurate diagnoses without a face-to-face interview or physical exam,4 whether use of tests and follow-up visits is appropriate, and whether antibiotics might be overprescribed. No studies have characterized the differences between eVisits and office visits. To fill this knowledge gap, we compared the care at eVisits and office visits for two conditions--sinusitis and urinary tract infection (UTI).
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In the citing paper
“All studies were from the United States and investigated populations with a confirmed diagnosis of sinusitis [22,26], UTI [22], or acute respiratory infection [25,27].”
From Impact of Remote Consultations on Antibiotic Prescribing in Primary Health Care: Systematic Review (2020) · cites this paper as [22]
Experimental — accuracy not yet measuredIn the citing paper
“We found 3 studies that reported the antibiotic-prescribing rate to be higher in remote settings than face-to-face consultations [19,22,27].”
From Impact of Remote Consultations on Antibiotic Prescribing in Primary Health Care: Systematic Review (2020) · cites this paper as [22]
In the citing paper
“The difference in prescribing rate ranged from 5% (n=201) to 50% (n=5165) [22].”
From Impact of Remote Consultations on Antibiotic Prescribing in Primary Health Care: Systematic Review (2020) · cites this paper as [22]
In the citing paper
“Intervention: 99%, control: 49% (P<.001)”
From Impact of Remote Consultations on Antibiotic Prescribing in Primary Health Care: Systematic Review (2020) · cites this paper as [22]
In the citing paper
“Intervention: 99%, control: 94% (P<.001)”
From Impact of Remote Consultations on Antibiotic Prescribing in Primary Health Care: Systematic Review (2020) · cites this paper as [22]
In the citing paper
“Mehrotra et al [22] concluded that PCPs were less likely to order a UTI-relevant test in face-to-face consultations (did not order: 8%, did order: 51%; P<.01), but more likely to prescribe an antibiotic for UTI in remote consultations.”
From Impact of Remote Consultations on Antibiotic Prescribing in Primary Health Care: Systematic Review (2020) · cites this paper as [22]
In the citing paper
“Of 2 studies assessing patients with suspected or confirmed UTI, 1 study found higher antibiotic-prescribing rates in remote consultations [22].”
From Impact of Remote Consultations on Antibiotic Prescribing in Primary Health Care: Systematic Review (2020) · cites this paper as [22]
In the citing paper
“In contrast to the findings for antibiotic-prescribing rate, the guideline-concordant antibiotic management for sinusitis and patients with UTI revealed no significant difference between remote and face-to-face consultations [22,26].”
From Impact of Remote Consultations on Antibiotic Prescribing in Primary Health Care: Systematic Review (2020) · cites this paper as [22]
In the citing paper
“In 3 studies, of which 2 were of high quality, researchers found higher antibiotic-prescribing rates in remote consultations than in direct PCP consultations [22,24,27].”
From Impact of Remote Consultations on Antibiotic Prescribing in Primary Health Care: Systematic Review (2020) · cites this paper as [22]
In the citing paper
“We found 4 observational studies that reported guideline-concordant prescribing rates or guideline-recommended prescribing rates, which measured the appropriateness of the prescriptions against local or national guidelines [22,25-27] (Table 2).”
From Impact of Remote Consultations on Antibiotic Prescribing in Primary Health Care: Systematic Review (2020) · cites this paper as [22]
In the citing paper
“We found 5 US-based retrospective cohort studies that investigated follow-up visit rates after initial consultation for the same presentation [18,19,22,25,26].”
From Impact of Remote Consultations on Antibiotic Prescribing in Primary Health Care: Systematic Review (2020) · cites this paper as [22]
In the citing paper
“However, Murray et al [18] and Mehrotra et al [22] found no significant difference in follow-up visit rates between the consultation types within the following 3 weeks and 30 days after the initial consultation, respectively.”
From Impact of Remote Consultations on Antibiotic Prescribing in Primary Health Care: Systematic Review (2020) · cites this paper as [22]
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Metadata
- Authors
- Mehrotra, A., Paone, S., Martich, G. D., Albert, S. M., & Shevchik, G. J.
- Affiliations
- University of Pittsburgh (US)
- UPMC Health System (US)
- Venue
- JAMA Internal Medicine
- Publisher
- American Medical Association (AMA)
- Published
- 2013-01-14
- Volume
- 173
- Issue
- 1
- Pages
- 72
- ISSN
- 2168-6106 (ISSN-L)
- PMC
- PMC3889474
- OpenAlex
- W2054939175
- Cited by
- 150
- References
- 5
- Citations by year
- 2026: 1 · 2025: 10 · 2024: 6 · 2023: 18 · 2022: 17 · 2021: 14 · 2020: 17 · 2019: 15 · 2018: 12 · 2017: 9 · 2016: 10 · 2015: 11 · 2014: 6 · 2013: 3
- FWCI
- 6.18
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- JAMA Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (KL2TR000146)
- National Institute of Allergy and Infectious Diseases (R21AI097759)
- National Center for Research Resources (KL2 RR24154-6, KL2RR024154)
- National Center for Advancing Translational Sciences
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
- Health Sciences › Medicine › Family Practice › Primary Care and Health Outcomes
- Keywords
- e-visits, telemedicine, physician visits, sinusitis, urinary tract infection, acute infection, primary care, antibiotic overprescription, diagnostic accuracy, health care costs, quality of care
- MeSH terms
- Anti-Bacterial Agents, Humans, Office Visits, Outcome and Process Assessment, Health Care, Physical Examination, Physician-Patient Relations, Practice Patterns, Physicians', Primary Health Care, Product Line Management, Sinusitis, Urinary Tract Infections, Remote Consultation, Internet, Electronic Health Records
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