E-Visits
Research Objectives
This trial evaluated the value of using a web-based clinical workflow prototype to conduct follow-up dermatologic care. In addition to the impact on patient satisfaction, the study examined if this will improve clinic workflow and enable urgent cases to be seen earlier.
Drivers
Patient access to dermatologic care is threatened by the existing dermatologist work-force shortage. The use of communication and information technologies has been promoted as the answer to our burdening supply and demand problem, though its efficacy as a substitute for in-patient visits has yet to be established.
Program Overview
A clinical workflow prototype was developed in collaboration with RelayHealth. The web-based system allowed patients with facial acne to have follow-up visits using a customized online questionnaire (‘e-visit’) and by uploading digital images of their faces. The patients were trained in how to take clinically-meaningful images and to use the system.
The system also allowed the physician to respond to the online questionnaire, prescribe new medications, and be reimbursed for the visit. Physicians had up to 4 business days to repsond to the patient's e-visit.
120 acne patients participated in this randomized controlled trial which began in September 2005. Over 90% of e-visit patients preferred e-visits to office visits. Physician satisfaction was very high and most physicians found the system efficient and easy to use. Quality of care between e-visits and standard care was found to be equivalent.
In this study, the e-visits model demonstrated more effective utilization of clinic resources and improved access to care for more urgent and complex cases. Our financial model supports the integration of e-visits into a practice, to increased efficiencies and differentiate the practice. The application of an e-visits platform is now being considered in other dermatology conditions, as well as in chronic disease management, such as diabetes and hypertension.
Results of this study was published in Arch Dermatol. 2010;146(4):406-411.
"I didn't feel alone at all, which is surprising because you're sitting at your desk alone... I was able to develop a nice rapport with my doctor." 
Christine (right), E-Visits patient
E-Visits Video