Impact of patient portal secure messages and electronic visits on adult primary care office visits

Telemed J E Health. 2014 Mar;20(3):192-8. doi: 10.1089/tmj.2013.0097. Epub 2013 Dec 18.


Introduction: Secure messages and electronic visits ("e-visits") through patient portals provide patients with alternatives to face-to-face appointments, telephone contact, letters, and e-mails. Limited information exists on how portal messaging impacts face-to-face visits in primary care.

Materials and methods: We conducted a retrospective cohort study of 2,357 primary care patients who used electronic messaging (both secure messages and e-visits) on a patient portal. Face-to-face appointment frequencies (visits/year) of each patient were calculated before and after the first message in a matched-pairs analysis. We analyzed visit frequencies with and without adjustments for a first message surge in visits, and we examined subgroups of high message utilizers and long-term users.

Results: Primary care patients who sent at least one message (secure message or e-visit) had a mean of 2.43 (standard deviation [SD] 2.3) annual face-to-face visits before the first message and 2.47 (SD 2.8) after, a nonsignificant difference (p=0.45). After adjustment for a first message surge in visits, no significant visit frequency differences were observed (mean, 2.35 annual visits per patient both before and after first message; p=0.93). Subgroup analysis also showed no significant change in visit frequency for patients with higher message utilization or for those who had used the messaging feature longer.

Conclusions: No significant change in face-to-face visit frequency was observed following implementation of portal messaging. Secure messaging and e-visits through a patient portal may not result in a change of adult primary care face-to-face visits.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Computer Security*
  • Electronic Health Records*
  • Electronic Mail
  • Female
  • Humans
  • Internet
  • Male
  • Middle Aged
  • Office Visits / statistics & numerical data*
  • Patient Access to Records
  • Physician-Patient Relations
  • Primary Health Care*
  • Retrospective Studies
  • Telemedicine*
  • Young Adult