Messaging, phone encounters up primary care visits in diabetes

(HealthDay)—For patients with diabetes in the patient-centered medical home (PCMH) health care delivery system, electronic messaging and telephone encounters increase primary care office visits, according to a study published in the July/August issue of the Annals of Family Medicine.

David T. Liss, Ph.D., from the Northwestern University Feinberg School of Medicine in Chicago, and colleagues used an interrupted time series design with a patient-quarter unit of analysis to examine whether use of copay-free secure messaging and telephone encounters correlated with office visit use in patients with diabetes. Data were collected for 18,486 adults with diabetes in three periods before, during, and after a PCMH redesign in an integrated health care delivery system.

The researchers observed a 28 percent increase in the mean quarterly number of primary care contacts between the pre- PCMH redesign baseline and the post-implementation periods. The increase was mainly due to increased secure messaging. An 8 percent decrease was noted in quarterly office visit use. Ten percent increases in secure message threads and telephone encounters correlated with 1.25 and 2.74 percent increases in office visits, respectively, in adjusted analyses. For all study periods and patient subpopulations, proportional increases in secure messaging and telephone encounters remained associated with increased office visit use.

"Our findings provide evidence on how new forms of patient-clinician communication may affect demand for office visits," the authors write.

Several authors disclosed financial ties to the Group Health Cooperative and affiliated medical groups, which partially funded the study.