Research Article
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Published Online: 27 February 2014

Impact of Patient Portal Secure Messages and Electronic Visits on Adult Primary Care Office Visits

Publication: Telemedicine and e-Health
Volume 20, Issue Number 3


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.

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Published In

cover image Telemedicine and e-Health
Telemedicine and e-Health
Volume 20Issue Number 3March 2014
Pages: 192 - 198
PubMed: 24350803


Published in print: March 2014
Published online: 27 February 2014
Published ahead of print: 18 December 2013
Accepted: 1 July 2013
Revision received: 27 June 2013
Received: 1 April 2013


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    Frederick North, MD
    Primary Care Internal Medicine, Mayo Clinic, Rochester, Minnesota.
    Sarah J. Crane, MD
    Primary Care Internal Medicine, Mayo Clinic, Rochester, Minnesota.
    Rajeev Chaudhry, MBBS
    Primary Care Internal Medicine, Mayo Clinic, Rochester, Minnesota.
    Jon O. Ebbert, MD
    Primary Care Internal Medicine, Mayo Clinic, Rochester, Minnesota.
    Karen Ytterberg, MD
    Community Pediatrics and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota.
    Sidna M. Tulledge-Scheitel, MD
    Primary Care Internal Medicine, Mayo Clinic, Rochester, Minnesota.
    Robert J. Stroebel, MD
    Primary Care Internal Medicine, Mayo Clinic, Rochester, Minnesota.


    Address correspondence to:Frederick North, MDPrimary Care Internal MedicineMayo Clinic200 First Street SWRochester, MN 55905E-mail: [email protected]

    Disclosure Statement

    No competing financial interests exist.

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