Healthcare Service Utilization under a New Virtual Primary Care Delivery Model. Telemedicine journal and e-health : the official journal of the American Telemedicine Association Cheung, L., Leung, T. I., Ding, V. Y., Wang, J. X., Norden, J., Desai, M., Harrington, R. A., Desai, S. 2018


BACKGROUND: Telemedicine holds great promise for changing healthcare delivery. While telemedicine has been used significantly in the direct-to-consumer setting, the use of telemedicine in a preventive primary care setting is not well studied.INTRODUCTION: ClickWell Care (CWC) is the first known implementation of a technology-enabled primary care model. We wanted to quantify healthcare utilization of primary care by patient characteristics and modality of care delivery.MATERIALS AND METHODS: Our study population included those who completed a visit to a CWC clinic between January 1, 2015 and September 30, 2015. We compared patients based on utilization of CWCs in-person and virtual visits across the following domains: patient demographics, distance from clinic, responses to a Health Risk Assessment, and top 10 conditions treated.RESULTS: Thousand two hundred seven patients completed a visit with a CWC physician in 2015. Nearly three-quarters of our patients were =40 years and sex was significantly different (p=0.015) between visit cohorts. The greatest representation of men (47%) was seen in the virtual-only cohort. Patients' proximity to the clinic was also significantly different across visit cohorts (p=0.018) with 44% of in-person-only and 34% of virtual-only patients living within 5 miles of Stanford Hospital.DISCUSSION: We found men were more likely to engage in virtual-only care. Young patients are willing to accept virtual care although many prefer to complete an in-person visit first.CONCLUSIONS: Our findings suggest that a "bricks-and-clicks" care model where telemedicine is supported by a brick-and-mortar location may be an effective way to leverage telemedicine to deliver primary care.

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