Direct-to-Consumer Virtual Urgent Care: A Descriptive Study and Outline for Common Practice Management Decisions

Abstract

Background

Direct-to-consumer (DTC) virtual urgent care (VUC) visits are increasingly popular across both for-profit and nonprofit healthcare systems; however, few peer-reviewed studies have described the ecology of a VUC program.

Design/Setting

In this retrospective cohort study, patients ( N = 2,216) received care through a VUC platform offered by a regional health system over an approximately 2-year period.

Results

Seventy-one percent of patients were identified as females. The age of the patients ranged from 18 to 85 years (median 39 years, interquartile range [IQR] 32–49 years). Eighty-four percent ( n = 1,906) of patients had a registered primary care provider (PCP), while 177 (8%) chose to self-pay for the VUC service. Seventy-six percent of visits occurred between Monday and Friday, and 71% ( n = 1,573) visits occurred between 8 am and 6 pm. The median provider response time was 24 minutes. Visits were conducted by videoconference 84% of the time; providers and patients spent a median of 7.4 minutes (IQR 4.3, 9.9 min) together in the video room. Seventy-seven percent of visits generated a prescription, of which 70% were on antibiotics.

Conclusions

Most virtual visits were initiated by existing health system patients with a primary care physician, and the majority of patients sought care during usual business hours. Most visits led to a prescription, most commonly an antibiotic. These data can help inform operational leaders who are considering how best to structure, staff, and develop key performance indicators for their own VUC programs. Additionally, these data challenge the notion that acute, episodic DTC encounters occur after-hours and are utilized by uninsured patients who lack a relationship with a primary care physician.