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.