Customizing Primary Care Delivery Using E-Visits

Abstract

Technologies that enable ``e-visits'' -- remote interactions between patients and physicians -- are touted as a way to improve and expand primary care. We study a setting in which a physician can divert some of the patient demand away from the office visits and into the e-visits, which utilize less of the physician's service capacity while maintaining an appropriate quality of care. We explicitly model a distinguishing feature of primary care settings: patient office revisit intervals are determined jointly by the physician and her patients. Using our model, we identify settings where patients and physicians adopt e-visits. We analytically characterize the impact of e-visits on key system outcomes: panel size, patient health, and physician compensation. Notably, we identify settings -- defined in terms of patient panel features, parameters of primary care delivery, and physician compensation scheme -- in which at least one of the system outcomes suffers under e-visits. Our modeling approach highlights the importance of considering patient and physician responses to primary care interventions to understand their full impact.

Keywords: Telemedicine, Healthcare, Service Operations, Information Technology Policy and Management, Contracts, Panel Size, Primary Care, Patient Revisit Intervals, Healthcare Operations