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Electronic visits offer accurate diagnoses, may lead to overprescribing of antibiotics
Date:11/19/2012

PITTSBURGH, Nov. 19, 2012 One of the first studies to compare patients who see their doctors in person to those who receive care through the Internet, known as an e-visit, underscores both the promise and the pitfalls of this technology.

Researchers at the University of Pittsburgh School of Medicine and UPMC found that patients who used e-visits for sinusitis and urinary tract infections (UTIs) were no more likely to need follow-up care than those who saw doctors in person. However, e-visit patients were more likely to receive antibiotics, and those with UTIs in particular were less likely to have relevant testing ordered by their physicians before receiving medication.

The findings, available online in the Archives of Internal Medicine and appearing in the Jan. 14 print edition, covered four primary care practices at UPMC, a leader in creating structured e-visits to improve access to care and convenience for patients. The researchers examined data from 5,165 visits for sinusitis and 2,954 visits for UTIs from Jan. 1, 2010, to May 1, 2011. Nine percent of the visits for sinusitis and 3 percent for UTIs occurred through the Internet at these four practices. In a UPMC e-visit, patients log in to a secure personal health record portal and answer a series of questions about their conditions. Doctors typically reply through the portal within a couple of hours, have full access to the patient's electronic medical record, and can prescribe drugs electronically.

"The main concern about e-visits, now offered in various forms by numerous health systems, has centered on quality issues--specifically about whether physicians can make accurate diagnoses without a physical exam; whether the use of tests and follow-up visits is appropriate, and whether antibiotics might be overprescribed," said Ateev Mehrotra, M.D., lead author of the study, associate professor in internal medicine at Pitt's School of Medicine and a researcher at the non-profit RAND Corp
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Contact: Wendy Zellner
ZellnerWL@upmc.edu
412-586-9777
University of Pittsburgh Schools of the Health Sciences
Source:Eurekalert

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