@Article{info:doi/10.2196/45641, author="Judson, Timothy J and Subash, Meera and Harrison, James D and Yeager, Jan and Williams, Aim{\'e}e M and Grouse, Carrie K and Byron, Maria", title="Patient Perceptions of e-Visits: Qualitative Study of Older Adults to Inform Health System Implementation", journal="JMIR Aging", year="2023", month="May", day="26", volume="6", pages="e45641", keywords="e-visit; patient portal message; digital health tool; patient portal; perception; attitude; qualitative; e-consult; remote care; remote visit; remote consult; vulnerable; messaging; telehealth; telemedicine; eHealth", abstract="Background: Electronic visits (e-visits) are billable, asynchronous patient-initiated messages that require at least five minutes of medical decision-making by a provider. Unequal use of patient portal tools like e-visits by certain patient populations may worsen health disparities. To date, no study has attempted to qualitatively assess perceptions of e-visits in older adults. Objective: In this qualitative study, we aimed to understand patient perceptions of e-visits, including their perceived utility, barriers to use, and care implications, with a focus on vulnerable patient groups. Methods: We conducted a qualitative study using in-depth structured individual interviews with patients from diverse backgrounds to assess their knowledge and perceptions surrounding e-visits as compared with unbilled portal messages and other visit types. We used content analysis to analyze interview data. Results: We conducted 20 interviews, all in adults older than 65 years. We identified 4 overarching coding categories or themes. First, participants were generally accepting of the concept of e-visits and willing to try them. Second, nearly two-thirds of the participants voiced a preference for synchronous communication. Third, participants had specific concerns about the name ``e-visit'' and when to choose this type of visit in the patient portal. Fourth, some participants indicated discomfort using or accessing technology for e-visits. Financial barriers to the use of e-visits was not a common theme. Conclusions: Our findings suggest that older adults are generally accepting of the concept of e-visits, but uptake may be limited due to their preference for synchronous communication. We identified several opportunities to improve e-visit implementation. ", issn="2561-7605", doi="10.2196/45641", url="https://aging.jmir.org/2023/1/e45641", url="https://doi.org/10.2196/45641", url="http://www.ncbi.nlm.nih.gov/pubmed/37234031" }