Principal Investigator(s)Johanna Bellon, MS, CFA
- Joel Stevans, DC
- Susan Cohen, PhD, APRN, FAAN
- Everette James, JD, MBA
- Ben Reynolds, MSPAS, PA-C
- Yuting Zhang, PhD
Background: While electronic delivery (eVisits) of healthcare services by advanced practice providers (APPs) is growing, literature defining the roles of different providers and comparing outcomes is lacking.
Introduction: We analyze two eVisit models at UPMC to compare their providers, physicians and APPs, and associated outcomes.
Materials and Methods: We identified all eVisits for the UPMC AnywhereCare Continuity (physician providers for existing patients) and Convenience (physician and APP providers for Pennsylvania residents) services (n=2,184) using Epic MyChart data (11/2013 – 8/2014). We compared eVisits by service and provider type for patient characteristics, volume, response time, primary diagnoses, and number of prescriptions. We utilized statistical tests to determine differences in patient characteristics and an ordinary least square linear regression, controlling for patient characteristics, to determine differences in prescribing.
Results: Of the completed eVisits (n=1,791), 72.5 percent were with APPs and 27.5 percent were with physicians. APP patients were younger, higher income and more likely to be unmarried. Sinusitis patients were more likely to utilize the Continuity service while urinary tract and upper respiratory infection were more likely to utilize the Convenience service. Finally, provider type was significantly associated with prescribing with APPs prescribing more.
Discussion: Some demographic variation exists between users of APPs versus physician eVisits. Provider response time seems more driven by service policy than provider type. Finally, variation exists between provider types in quantities of prescriptions written.
Conclusions: As health systems and policymakers develop protocols and reimbursement strategies for eVisits, these model considerations will be important.