Asynchronous virtual patient visits streamline doc workflow

By Mark Terry 

Asynchronous virtual visits by chronically ill patients significantly reduced encounter times for doctors, according to research published online this month in Telemedicine and e-Health.

For the study, researchers Ronald Dixon, M.D. and Latha Raos developed a web-based questionnaire for patients that focused on 10 chronic illnesses: asthma, anxiety disorders, back pain, depression, diabetes, gastroesophageal reflux disease, headaches, hypertension, obesity, and osteoarthritis. Nine physicians and one nurse practitioner at a Massachusetts General Hospital ambulatory internal medicine practice site, MGH-Beacon Hill Practice, participated, along with 175 adult patients.

Scripts were carefully developed by the research team "based on evidence-based guidelines and standard medical practices." The researchers noted that the scripts differed from typical patient portals in that they provided "the clinical content and documentation by which concrete medical decision-making is made."

Physicians would review the patient input at specific times set aside in their schedules (hence the asynchronous part) and make recommendations within one business day. They then would make recommendations to the patient to continue current treatment, to schedule a follow-up phone call, video chat, or to set up a face-to-face appointment, along with any other specific instructions. On average, patients spent 8.31 minutes complete the questionnaire and physicians spent an average of 3.62 minutes reviewing each patient's responses and making recommendations. Follow-up surveys found high satisfaction levels for both patients and physicians.

Recent research has found that telemedicine can improve healthcare delivery to specific populations. What's more, a recent EY report titled "Shaping Your Telehealth Strategy" outlined various strategies for successful telehealth programs, including conducting a needs assessment, creating a detailed comprehensive telehealth design, and a slow and careful deployment.

"In enabling healthcare organization to provide 'anytime, anywhere' care to patients, operate more efficiency and cost effectively, and generate new sources of revenue, telehealth programs are an important part of the strategy to achieve these goals," the EY report concluded.

The findings of Dixon and Rao's study reached a similar conclusion.

"The present study suggests that once patients and physicians are given the opportunity to use an alternative system of care, the experience can be a satisfying one," they said. "Making these systems adapt to the office workflow is very important to clinician satisfaction."

To read more:
- read the article (.pdf)

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