# Patient choice of telemedicine encounters

> **NIH AHRQ R01** · KAISER FOUNDATION RESEARCH INSTITUTE · 2020 · $380,497

## Abstract

SUMMARY
This research proposal is in response to AHRQ (NOT-HS-16-009) and examines the quality and safety
impacts of real-time patient-provider video and telephone visits, interactive health information technology
(IT) tools with potential to engage patients through convenient health care access. Telemedicine can offer
patients the choice to access a provider visit without the obstacles of securing transportation, arranging
time-off from work or care-giving, or spending time in a waiting-room. Even as American patients are
increasingly purchasing internet-based telemedicine visits from third party services without in-person facilities,
gaps remain in the scientific evidence about patient adoption of telemedicine for primary care encounters
(compared with in-person visits). This study will examine a 2016 health IT implementation offering patient -
initiated primary care telemedicine encounters through the patient portal of an integrated healthcare
delivery system. All patients scheduling an appointment with a primary care provider through the portal
(website and mobile application) choose directly between a traditional in -person visit and a telemedicine
visit, either by video or telephone. Over a five year study period (2016 -2020), we will examine a large
sample of patient-scheduled telemedicine appointments, including over 50,000 video visits and 500,000
telephone visits, compared with millions of patient-scheduled in-person visits. Using patient surveys
(N=1,500) and stakeholder key informant interviews, we will examine the experiences of telemedicine users
and decision-makers, including technology usability, convenience, and patient-reported outcomes. In the study
setting, this novel patient telemedicine access is fully integrate d with patients’ own existing health care
providers and comprehensive electronic health record (EHR). We will examine patient clinical concerns and
access measures associated with the choice of a telemedicine encounter compared with in-person encounters
(Aim 1), and the quality and safety of the telemedicine encounters through guideline-recommended health care
processes (prescribing and ordering), follow-up visits, and events ( emergency department visits) (Aim 2). We
will test the hypotheses that care processes and short-term event rates for patient-initiated telemedicine
encounters will not be worse than for patient-initiated in-person visits (non-inferiority hypothesis), while
accounting for patient engagement, recent changes in health status, case-mix, cost-sharing for in-person visits,
internet access, and patient demographic and socio-economic characteristics. By examining an early adopter
of the technologies, and a large and diverse patient population, this project has the potential to provide timely
evidence to inform emerging telehealth policies, technology adoption decisions, and real world use by patients
and clinicians.

## Key facts

- **NIH application ID:** 9882948
- **Project number:** 5R01HS025189-03
- **Recipient organization:** KAISER FOUNDATION RESEARCH INSTITUTE
- **Principal Investigator:** Mary Reed
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** AHRQ
- **Fiscal year:** 2020
- **Award amount:** $380,497
- **Award type:** 5
- **Project period:** 2018-05-15 → 2023-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9882948

## Citation

> US National Institutes of Health, RePORTER application 9882948, Patient choice of telemedicine encounters (5R01HS025189-03). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/9882948. Licensed CC0.

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