This study aimed to determine the feasibility of patient-initiated online Internet urgent care visits, and to describe patient characteristics, scope of care, provider adherence to protocols, and diagnostic and therapeutic utilization. A total of 456 unique patients were seen via Internet-based technology during the study period, generating 478 consecutive total patient visits. Of the 82 patients referred for an in-person evaluation, 75 patients (91.5%) reported to the clinic as instructed. None of the 82 patients recommended for in-person evaluation required an emergency department referral, hospital admission or urgent consultative referral. We conclude that real-time online primary and urgent care visits are feasible, safe and potentially beneficial in increasing convenient access to urgent and primary care.
HershWRHickamDHSeveranceSMDanaTLKragesKPHelfandM. Diagnosis, access and outcomes: Update of a systematic review of telemedicine services. J Telemed Telecare2006; 12(suppl 2): 3–31.
2.
SzeftelRFedericoCHakakRSzeftelZJacobsonM. Improved access to mental health evaluation for patients with developmental disabilities using telepsychiatry. J Telemed Telecare2012; 18(6): 317–321.
3.
AdlerGPritchettLRKauthMRNadorffD. A Pilot Project to Improve Access to Telepsychotherapy at Rural Clinics. Telemedicine and e-Health2014; 20(1): 83–85.
4.
WhitedJD. Teledermatology research review. Int J Dermatol2006; 45(3): 220–229.
5.
WhitedJDHallRPFoyMEMarbreyLEGrambowSCDudleyTK. Patient and clinician satisfaction with a store-and-forward teledermatology consult system. Telemedicine Journal & E-Health2004; 10(4): 422–431.
6.
WhitedJDDattaSHallRPFoyMEMarbreyLEGrambowSC. An economic analysis of a store and forward teledermatology consult system. Telemedicine Journal and E-health2003; 9(4): 351–360.
7.
WhitedJDHallRPFoyMEMarbreyLEGrambowSCDudleyTK. Teledermatology's impact on time to intervention among referrals to a dermatology consult service. Telemedicine Journal and E-Health2002; 8(3): 313–321.
8.
MallettR. Teledermatology in practice. Clin Exp Dermatol2003; 28(4): 356–359.
9.
HaukipuroKOhinmaaAWinbladILindenTVuolioS. The feasibility of telemedicine for orthopaedic outpatient clinicsa randomized controlled trial. J Telemed Telecare2000; 6(4): 193–198.
RogersMASmallDBuchanDAButchCAStewartCMKrenzerBE. Home monitoring service improves mean arterial pressure in patients with essential hypertensionA randomized, controlled trial. Ann Intern Med2001; 134(11): 1024–1032.
12.
MalasanosTHBurlingameJBYoungbladeLPatelBDMuirAB. Improved access to subspecialist diabetes care by telemedicine: cost savings and care measures in the first two years of the FITE diabetes project. J Telemed Telecare2005; 11(suppl 1): 74–76.
13.
KobbRHoffmanNLodgeRKlineS. Enhancing elder chronic care through technology and care coordination: report from a pilot. Telemedicine Journal and e-HEALTH2003; 9(2): 189–195.
14.
McConnochieKMConnersGPBrayerAFGoeppJHerendeenNEWoodNE. Effectiveness of telemedicine in replacing in-person evaluation for acute childhood illness in office settings. Telemedicine Journal & e-Health2006; 12(3): 308–316.
15.
Dharmar M, Romano PS, Kuppermann N, Nesbitt TS, Cole SL, Andrada ER, et al. Impact of Critical Care Telemedicine Consultations on Children in Rural Emergency Departments. Crit Care Med 2013.
16.
AlbertSMShevchikGJPaoneSMartichGD. Internet-based medical visit and diagnosis for common medical problems: experience of first user cohort. Telemed J E Health2011 May; 17(4): 304–308.
17.
Mehrotra A, Paone S, Martich GD, Albert SM, Shevchik GJ. Characteristics of Patients Who Seek Care via eVisits Instead of Office Visits. Telemedicine and e-Health 2013.
18.
AdamsonSCBachmanJW. Pilot Study of Providing Online Care in a Primary Care Setting. Mayo Clin Proc2010 08/01; 85(8): 704–710.
YoungLBChanPSLuXNallamothuBKSassonCCramPM. Impact of telemedicine intensive care unit coverage on patient outcomes: a systematic review and meta-analysis. Arch Intern Med2011; 171(6): 498–498.
21.
ShahMNGillespieSMWoodNWassermanEBNelsonDLDozierA. High-Intensity Telemedicine-Enhanced Acute Care for Older Adults: An Innovative Healthcare Delivery Model. J Am Geriatr Soc2013; 61(11): 2000–2007.
22.
ShahMNMcDermottRGillespieSMPhilbrickEBNelsonD. Potential of Telemedicine to Provide Acute Medical Care for Adults in Senior Living Communities. Acad Emerg Med2013; 20(2): 162–168.
23.
WhittenPSMairFSHaycoxAMayCRWilliamsTLHellmichS. Systematic review of cost effectiveness studies of telemedicine interventions. BMJ: British Medical Journal2002; 324(7351): 1434–1434.
24.
WestSPLaguaCTriefPMIzquierdoRWeinstockRS. Goal setting using telemedicine in rural underserved older adults with diabetes: experiences from the informatics for diabetes education and telemedicine project. Telemedicine and e-Health2010; 16(4): 405–416.
25.
SheaSWeinstockRSTeresiJAPalmasWStarrenJCiminoJJ. A randomized trial comparing telemedicine case management with usual care in older, ethnically diverse, medically underserved patients with diabetes mellitus: 5 year results of the IDEATel study. Journal of the American Medical Informatics Association2009; 16(4): 446–456.
26.
SpeedieSMFergusonASSandersJDoarnCR. Telehealth: the promise of new care delivery models. Telemedicine and e-Health2008; 14(9): 964–967.
27.
McConnochieKMConnersGPBrayerAFGoeppJHerendeenNEWoodNE. Differences in diagnosis and treatment using telemedicine versus in-person evaluation of acute illness. Ambulatory Pediatrics2006; 6(4): 187–195.
28.
DorseyEDeuelLMVossTSFinniganKGeorgeBPEasonS. Increasing access to specialty care: a pilot, randomized controlled trial of telemedicine for Parkinson's disease. Movement Disorders2010; 25(11): 1652–1659.
29.
Edirippulige S, Martin-Khan M, Beattie E, Smith AC, Gray LC. A systematic review of telemedicine services for residents in long term care facilities. J Telemed Telecare 2013.
30.
WallacePHainesAHarrisonRBarbourJThompsonSJacklinP. Joint teleconsultations (virtual outreach) versus standard outpatient appointments for patients referred by their general practitioner for a specialist opinion: a randomised trial. The lancet2002; 359(9322): 1961–1968.
