JMIR Publications

ABSTRACT

Background:

Electronic visits (E-visits) are billable, asynchronous patient-initiated messages that require at least five minutes of medical decision-making by a provider. Unequal use of patient portal tools like E-visits by certain patient populations may worsen health disparities.

Objective:

In this qualitative study, we aimed to understand patient perceptions of E-visits, including their perceived utility, barriers to use, and care implications, with a focus on vulnerable patient groups.

Methods:

We conducted a qualitative study using in-depth structured individual interviews with patients from diverse backgrounds to assess their knowledge and perceptions surrounding E-visits as compared with unbilled portal messages and other visit types. We used content analysis to analyze interview data.

Results:

We conducted 20 interviews, all in adults over 65 years of age. We identified four overarching coding categories/themes. First, participants were generally accepting of the concept of E-visits and willing to try them. Second, nearly two-thirds of participants voiced a preference for synchronous communication. Third, participants had specific concerns about the name “E-visit” and when to choose this type of visit in the patient portal. Fourth, some participants indicated discomfort using or accessing technology for E-visits. Financial barriers to use of E-visits was not a common theme.

Conclusions:

Our findings suggest that older adults are generally accepting of the concept of E-visits, but uptake may be limited due to their preference for synchronous communication. We identified several opportunities to improve E-visit implementation.