Young-Rock Hong1, Kea Turner2, Sandhya Yadav2, Jinhai Huo2, Arch G Mainous3. 1. Department of Health Services Research, Management and Policy, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States. Electronic address: youngrock.h@phhp.ufl.edu. 2. Department of Health Services Research, Management and Policy, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States. 3. Department of Health Services Research, Management and Policy, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States; Department of Community Health and Family Medicine, University of Florida, Gainesville, FL, United States.
Abstract
BACKGROUND: Electronic visits (e-visits) have the potential to expand patients' access to care and reduce healthcare costs. We aimed to describe trends in e-visit adoption among the U.S. office-based physicians and examine physician-and practice-level factors associated with e-visit adoption. METHODS: This was a retrospective observational study of 2011-2015 National Ambulatory Medical Care Survey. We used the Cochran-Armitage tests to evaluate trend changes in e-visit adoption among the U.S. office-based physicians. Multivariable logistic regression was used to calculate the odds of adopting e-visits adjusting for physician and practice characteristics. RESULTS: Our sample included 10,767 respondents, representing 327,836 office-based physicians in the U.S. Our analysis indicated that, in 2015, 15.9% of physicians adopted e-visits, which is a minor increase of 2.2% in total utilization of 13.7% in 2011. The likelihood of adopting e-visits was 2.7 times higher for physicians who have fully implemented electronic health records systems compared (odds ratio, 2.66, [95% CI, 2.16-3.28]) to physicians who have not implemented EHRs. Other predictors of e-visit adoption included primary care rather than specialty care, capitated payment model, and having a secure messaging capability. CONCLUSIONS: Our study demonstrates that overall e-visit adoption is low and has not been implemented as rapidly as other health information technologies. While use of secure information technology could be a facilitator for e-visit implementation, there are other barriers affecting widespread adoption. E-visits are a promising strategy for increasing patients' access to care. Future research is needed to explore implementation barriers that might be impeding e-visit adoption.
BACKGROUND: Electronic visits (e-visits) have the potential to expand patients' access to care and reduce healthcare costs. We aimed to describe trends in e-visit adoption among the U.S. office-based physicians and examine physician-and practice-level factors associated with e-visit adoption. METHODS: This was a retrospective observational study of 2011-2015 National Ambulatory Medical Care Survey. We used the Cochran-Armitage tests to evaluate trend changes in e-visit adoption among the U.S. office-based physicians. Multivariable logistic regression was used to calculate the odds of adopting e-visits adjusting for physician and practice characteristics. RESULTS: Our sample included 10,767 respondents, representing 327,836 office-based physicians in the U.S. Our analysis indicated that, in 2015, 15.9% of physicians adopted e-visits, which is a minor increase of 2.2% in total utilization of 13.7% in 2011. The likelihood of adopting e-visits was 2.7 times higher for physicians who have fully implemented electronic health records systems compared (odds ratio, 2.66, [95% CI, 2.16-3.28]) to physicians who have not implemented EHRs. Other predictors of e-visit adoption included primary care rather than specialty care, capitated payment model, and having a secure messaging capability. CONCLUSIONS: Our study demonstrates that overall e-visit adoption is low and has not been implemented as rapidly as other health information technologies. While use of secure information technology could be a facilitator for e-visit implementation, there are other barriers affecting widespread adoption. E-visits are a promising strategy for increasing patients' access to care. Future research is needed to explore implementation barriers that might be impeding e-visit adoption.
Authors: Paul T Greenfield; Wesley J Manz; Emily L DeMaio; Sage H Duddleston; John W Xerogeanes; T Scott Maughon; Corey C Spencer; Alexander Dawes; Scott D Boden; Kyle E Hammond; Eric R Wagner; Michael B Gottschalk; Charles A Daly; Mathew W Pombo Journal: HSS J Date: 2021-02-21