Impact of patient portal secure messages and electronic visits on adult primary care office visits

Frederick North, Sarah J. Crane, Rajeev Chaudhry, Jon O. Ebbert, Karen Ytterberg, Sidna M. Tulledge-Scheitel, Robert J. Stroebel

Research output: Contribution to journalArticlepeer-review

50 Scopus citations


Introduction: Secure messages and electronic visits ("e-visits") through patient portals provide patients with alternatives to face-to-face appointments, telephone contact, letters, and e-mails. Limited information exists on how portal messaging impacts face-to-face visits in primary care. Materials and Methods: We conducted a retrospective cohort study of 2,357 primary care patients who used electronic messaging (both secure messages and e-visits) on a patient portal. Face-to-face appointment frequencies (visits/year) of each patient were calculated before and after the first message in a matched-pairs analysis. We analyzed visit frequencies with and without adjustments for a first message surge in visits, and we examined subgroups of high message utilizers and long-term users. Results: Primary care patients who sent at least one message (secure message or e-visit) had a mean of 2.43 (standard deviation [SD] 2.3) annual face-to-face visits before the first message and 2.47 (SD 2.8) after, a nonsignificant difference (p=0.45). After adjustment for a first message surge in visits, no significant visit frequency differences were observed (mean, 2.35 annual visits per patient both before and after first message; p=0.93). Subgroup analysis also showed no significant change in visit frequency for patients with higher message utilization or for those who had used the messaging feature longer. Conclusions: No significant change in face-to-face visit frequency was observed following implementation of portal messaging. Secure messaging and e-visits through a patient portal may not result in a change of adult primary care face-to-face visits.

Original languageEnglish (US)
Pages (from-to)192-198
Number of pages7
JournalTelemedicine and e-Health
Issue number3
StatePublished - Mar 1 2014


  • Information management
  • Primary care
  • Telemedicine
  • e-health

ASJC Scopus subject areas

  • Health Informatics
  • Health Information Management


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