Interest in Mental Health Care Among Patients Making eVisits

Objectives: The Internet allows patients opportunities for eVisits, in which a patient communicates electronically with a clinician who then makes a diagnosis and treatment recommendations. The status of mental health eVisits in these systems is still evolving. We examined features of mental health eVisits in a patient portal that did not explicitly provide an option for such care. Study Design: Retrospective review of patient portal use. Methods: Between April 2009 and mid-June 2012, over 2000 patients completed a total of 3601 eVisits through a patient portal at the University of Pittsburgh Medical Center. Although eVisits for mental health conditions were not explicitly offered, patients could choose an "other" option for the eVisit. We tracked diagnoses given by physicians in these "other" eVisits using Clinical Classification Software developed in the Healthcare Cost and Utilization Project. Results: Of 685 patients choosing the "other" option for their eVisit (23.9% of patients making eVisits), 13.4% received mental health diagnoses, primarily anxiety and depression disorders. These patients represented 4% of all patients making eVisits. They were younger (41.1 +/- 12.4 vs 46.2 +/- 13.2; P < .001) and more likely to be female (82.6% vs 71.1%; P = .017) than patients not receiving mental health diagnoses. It took physicians longer to respond to mental health eVisits (same day in 71% of diagnoses involving mental health but 79.0% in all other diagnoses, P = .054). Conclusions: Patients are interested in eVisits for mental health care. Protocols that allow prompt attention to common mental health concerns in eVisits may be needed.