Exploring how virtual primary care visits affect patient burden of treatment

Abstract Background There is growing emphasis on the role of digital solutions to support chronic disease management. This has the potential to increase the burden patients experience in managing their health by offloading care from the health system to patients. This paper explores the effects of virtual visits on patient burden using an explicit framework measuring the work patients do to care for their health and challenges that exacerbate burden. Methods This mixed methods study evaluates a large pilot implementation of virtual visits (video, audio, and asynchronous messaging with providers) in primary care in Ontario, Canada. Participants were recruited using convenience sampling from patients using a virtual visit platform to participate in semi-structured interviews or a survey including a free-text response. We conducted 17 interviews and reviewed 427 free text responses related to value or burden of these visits. Qualitative analyses mapped patients’ feedback on their experience to the framework on patient burden. Main findings Virtual visits appear to reduce the work patients must do to manage their care by 1) improving access, convenience, and time needed for medical appointments, and 2) making it easier to get information and support for chronic disease management. They also alleviate perceived burden by improving continuity of care, experience of care, and providing some cost savings. Conclusions Virtual visits reduced overall patient burden of treatment by decreasing the required patient effort of managing medical appointments and monitoring their health and minimizing challenges experienced when accessing care. For regions that want to improve patient experience of care, virtual visits are likely to be of benefit. There is need for further research on the generalizability of the findings herein, particularly for high-needs populations under-represented such as those of low socioeconomic status and those in rural and remote locations.