Internet-based medical visit and diagnosis for common medical problems: experience of first user cohort

Telemed J E Health. 2011 May;17(4):304-8. doi: 10.1089/tmj.2010.0156. Epub 2011 Apr 1.


Objective: Internet-based medical visits, or "structured e-Visits," allow patients to report symptoms and seek diagnosis and treatment from their doctor over a secure Web site, without calling or visiting the physician's office. While acceptability of e-Visits has been investigated, outcomes associated with e-Visits, that is, whether patients receiving diagnoses receive appropriate care or need to return to the doctor, remain unexplored.

Materials and methods: The first 156 e-Visit users from a large family medicine practice were surveyed regarding their experience with the e-Visit and e-Visit outcomes. In addition, medical records for patients making e-Visits were reviewed to examine need for follow-up care within 7 days.

Results: Interviews were completed with 121 patients (77.6% participation). The most common type of e-Visit was for "other" symptoms or concerns (37%), followed by sinus/cold symptoms (35%). Back pain, urinary symptoms, cough, diarrhea, conjunctivitis, and vaginal irritation were each less frequent (<10%). A majority, 61% completed e-Visits with their own physician. The majority of patients (57.0%) reported receipt of a diagnosis without need for follow-up beyond a prescription; 75% of patients thought the e-Visit was as good as or better than an in-person visit, and only 11.6% felt that their concerns or questions were incompletely addressed. In a review of medical records, 16.9% had a follow-up visit within 7 days, mostly for the same condition. Four of these were on the same day as the e-Visit, including one emergency department visit.

Conclusions: Outcomes for the e-Visit suggest that it is an appropriate and potentially cost-saving addition to in-person delivery of primary care.

MeSH terms

  • Access to Information*
  • Adolescent
  • Adult
  • Cohort Studies
  • Cost Savings
  • Female
  • Health Care Surveys
  • Humans
  • Information Dissemination / methods*
  • Internet / organization & administration*
  • Male
  • Middle Aged
  • Pennsylvania
  • Physician-Patient Relations*
  • Residence Characteristics*
  • Surveys and Questionnaires
  • Telemedicine / organization & administration*
  • Young Adult