Impact of e-consults on return visits of primary care patients.

Virtual medicine is growing in importance as the cost of medical care rises and the potential for Internet applications expands. The purpose of this study was to evaluate the impact of e-consults (ECs) (also known as virtual specialty consultations) on the frequency of return visits for family medicine patients. Two groups of patients were compared: those for whom an EC was requested (n = 228) and a comparison group for whom face-to-face referrals occurred (n = 500). Two types of early return office visits were used as dependent variables: those within 2 weeks for any reason and those for the same reason. No significant difference was found in rates of early return visits for the same reason. The percent of return visits for any reason within 2 weeks was 38.2% for EC patients and 27.6% for patients receiving face-to-face specialist visits (p < .01). After adjusting for comorbidity, age, sex, and marital status, the odds of an early return visit for any reason after an EC were elevated (odds ratio, 1.88; confidence interval, 1.33-2.66; P < .01). E-consults by referral specialists were associated with increased odds of early return visits for primary care patients with a primary care provider.