A Comparison of Care at E-visits and Physician Office Visits for Sinusitis and Urinary Tract Infection

Internet capabilities create the opportunity for eVisits, in which physicians and patients interact virtually instead of face-to-face. In an eVisit, a patient logs into her secure personal health record internet portal and answers a series of questions about her condition. This written information is sent to the physician, who makes a diagnosis, orders necessary care, puts a note in the patient’s electronic medical record (EMR), and replies to the patient via the secure portal within several hours. eVisits are offered by numerous health systems and are commonly reimbursed by health plans.1,2 eVisits typically focus on care for acute conditions, such as minor infections. There are several potential advantages of eVisits, including convenience and efficiency (avoiding travel and time) and lower costs.3 Further, eVisits can be provided by the patient’s primary care physician (PCP) instead of a physician at an emergency department or urgent care center. The main concerns about eVisits center on quality issues: whether physicians can make accurate diagnoses without a face-to-face interview or physical exam,4 whether use of tests and follow-up visits is appropriate, and whether antibiotics might be overprescribed. No studies have characterized the differences between eVisits and office visits. To fill this knowledge gap, we compared the care at eVisits and office visits for two conditions--sinusitis and urinary tract infection (UTI).