Prevalence and Factors Associated with Family Physicians Providing E-Visits

J Am Board Fam Med. 2019 Nov-Dec;32(6):868-875. doi: 10.3122/jabfm.2019.06.190081.

Abstract

Purpose: The use of telemedicine has grown in recent years. As a subset of telemedicine, e-visits typically involve the evaluation and management of a patient by a physician or other clinician through a Web-based or electronic communication system. The national prevalence of e-visits by primary care physicians is unclear as is what factors influence adoption. The purpose of this study was to examine the prevalence of family physicians providing e-visits and associated factors.

Methods: A national, cross-sectional practice demographic questionnaire for 7580 practicing family physicians was utilized. Bivariate statistics were calculated and logistic regression was conducted examining both physician level and practice level factors associated with offering e-visits.

Results: The overall prevalence of offering e-visits was 9.3% (n = 702). Compared with private practice physicians, other physicians were more likely to offer e-visits if their primary practice was an academic health center/faculty practice (odds ratio [OR], 1.73; 95% CI, 1.03 to 2.91), managed care/health maintenance organization (HMO) practice (OR, 9.79; 95% CI, 7.05 to 13.58), hospital-/health system-owned medical practice (not including managed care or HMO) (OR, 2.50; 95% CI, 1.83 to 3.41), workplace clinic (OR, 2.28; 95% CI, 1.43 to 3.63), or federal (military, Veterans Administration [VA]/Department of Defense) (OR, 4.49; 95% CI, 2.93 to 6.89). Physicians with no official ownership stake (OR, 0.44; 95% CI, 0.28 to 0.68) or other ownership arrangement (OR, 0.29; 95% CI, 0.12 to 0.71) had lower odds of offering e-visits compared with sole owners.

Conclusion: Fewer than 10% of family physicians provided e-visits. Physicians in HMO and VA settings (ie, capitated vs noncapitated models) were more likely to provide e-visits, which suggests that reimbursement may be a major barrier.

Keywords: Cross-Sectional Studies; Delivery of Health Care; Family Physicians; Logistic Models; Primary Care Physicians; Surveys and Questionnaires; Telemedicine.

MeSH terms

  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Office Visits / economics
  • Office Visits / statistics & numerical data
  • Office Visits / trends*
  • Physicians, Family / economics
  • Physicians, Family / statistics & numerical data*
  • Physicians, Family / trends
  • Practice Patterns, Physicians' / economics
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Practice Patterns, Physicians' / trends
  • Primary Health Care / economics
  • Primary Health Care / statistics & numerical data
  • Primary Health Care / trends
  • Private Practice / economics
  • Private Practice / statistics & numerical data
  • Private Practice / trends
  • Reimbursement Mechanisms / economics
  • Reimbursement Mechanisms / statistics & numerical data
  • Telemedicine / economics
  • Telemedicine / statistics & numerical data
  • Telemedicine / trends*
  • United States