Evidence map›Paper›PMID 37072203›Full record

ArticleCanadian family physician Medecin de famille canadien2023

Impact of virtual visits on primary care physician work flows.

Jamie K Fujioka, Megan Nguyen, Michelle Phung, Onil Bhattacharyya, Leah Kelley, Vess Stamenova, Nike Onabajo, Michael Kidd, Laura Desveaux, Ivy Wong and 2 more

Open access · diamondAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Canadian family physician Medecin de famille canadien, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.4field-weighted citation impact, top 19% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 5 citations in OpenAlex.

  1. Article
  2. Article
  3. Review
  4. The remains of a pandemic.Canadian family physician Medecin de famille canadien · 2023
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 11 institutions in 6 countries.

Jamie K FujiokaResearch coordinator at Women's College Hospital Institute for Health System Solutions and Virtual Care (WIHV) in Toronto, Ont.
Megan NguyenStrategist at Throughline Strategy Inc in Toronto.
Michelle PhungProgram manager at the Center for Artificial Intelligence in Medicine & Imaging at Stanford University School of Medicine in Palo Alto, CA.
Onil BhattacharyyaFrigon Blau Chair in Family Medicine Research and Director of WIHV. He is Lead at the Centre for Digital Health Evaluation in Toronto. He practises family medicine and is Associate Professor in the Department of Family and Community Medicine and the Institute of Health Policy, Management and Evaluation (DFCM) at the University of Toronto (U of T). He is national Co-chair of the Primary and Integrated Health Care Innovations Network and has been a Harkness Fellow in Health Care Policy and Practice at the Commonwealth Fund in New York, NY, and a Takemi Fellow at the Harvard T.H. Chan School of Public Health in Boston, MA.
Leah KelleyGraduate of the U of T Faculty of Law.
Vess StamenovaResearch lead at WIHV.
Nike OnabajoProject manager at North York Ontario Health Teams in Toronto.
Michael KiddPrincipal Medical Advisor and Deputy Chief Medical Officer with the Australian Government Department of Health and Aged Care, Professor of Primary Care Reform at the Australian National University in Canberra, and Adjunct Professor in the DFCM at U of T.
Laura DesveauxScientific Lead and Learning Health System Program Lead at Trillium Health Partners in Toronto.
Ivy WongDirector of Ontario Health Team and Transformation at North York General Hospital and Backbone Lead of North York Toronto Health Partners Ontario Health Team.
R Sacha BhatiaSenior Vice President of Population Health and Value Based Care at Ontario Health and a cardiologist at the University Health Network in Toronto.
Payal AgarwalPractising family physician affiliated with the DFCM at U of T and Innovation Fellow at WIHV.
North York General Hospital · CAArtificial Intelligence in Medicine (Canada) · CAAustralian Government · AUCommonwealth Fund · USDanish Academy of Technical Sciences · DKGlobal Strategy Group · USThe University of Law · GBTrillium Health Centre · CAUniversity Health Network · CAWihuri Research Institute · FIWomen's College Hospital · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo understand the impact of virtual visits on primary care physician (PCP) work flows.

designQualitative semistructured interviews.

settingPrimary care practices within 5 regions in southern Ontario.

participantsPhysicians representing primary care practices of various sizes and remuneration models (eg, capitation and fee-for-service models).

methodsInterviews were conducted with PCPs involved in a large-scale pilot project implementing virtual visits (via a Web-based application) into clinical practices. Convenience and purposive sampling were used to recruit PCPs between January 2018 and March 2019. To obtain a representative sample, participants were sought from a variety of practice types and geographic regions. High and low users of virtual visits were included. Interviews were audiorecorded and transcribed. An inductive thematic analysis was used to identify prominent themes and subthemes. MAIN

findingsTwenty-six physicians were interviewed (n=15 using convenience sampling and n=11 through purposive sampling). Four themes were identified: PCPs employ diverse approaches to integrate virtual care into their work flow; PCPs recognize that implementing virtual visits requires upfront time and effort but have variable perceptions regarding long-term impact of virtual care on processes; asynchronous messaging is preferable to synchronous audio or video visits; and strategies were identified to improve the integration of virtual visits.

conclusionThe potential of virtual care to improve work flow is dependent on the way these visits are implemented and used. Dedicated time for implementation, emphasis on using asynchronous secure messaging, and access to clinical champions and structured change management support were associated with more seamless integration of virtual visits.

Indexed as

Physicians, Primary CareFee-for-Service PlansHumansOntarioPilot ProjectsWorkflow

Identifiers

PMID37072203
PMCPMC10112728
OpenAlexW4366336253

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.