eVisit: a pilot study of a new kind of healthcare delivery.

Patient online eVisits are gaining momentum due to increasing consumer demand for improved access to clinical services, availability of new technologies to deploy such services and development of reimbursement initiatives by major payers. The eVisit service provides patients with an online consultation through a series of structured, secure message exchanges with a physician, providing an alternative for onsite office visits and non-reimbursed phone-based care. In this study, we evaluate a pilot deployment of eVisits in a primary care clinic providing online consultation service for 7 simple health conditions at its three locations. We examine usage data over 3 months and survey and interview results for trends in adoption, demographic and temporal patterns of usage, clinician and patient expectations and experiences, and challenges to sustainability of the service. Based on our analysis, we conclude that the eVisit pilot was a success. Patients valued the new service being offered as demonstrated by a rapid increase in usage. The quality of service was good with fast turnaround times and few exchanges to resolve a request. These positive outcomes combined with a reimbursement model are promising indications of sustainability but several challenges remain.