Vol. 3 No. 5 (2023)
Health Technology Reviews

Evidence Base for Virtual Primary Care

Published May 30, 2023

Key Messages

  • The aim of this report was to identify and organize evidence and summarize key findings on the clinical effectiveness, cost-effectiveness, patient and provider experiences and preferences, and equity considerations of virtual primary care. It includes 60 relevant reports, of which we summarized 6 systematic reviews (SRs) and organized 54 additional reports into annotated reference lists.
  • This report was not a formal evidence synthesis, and no conclusions were formed about the value of virtual primary care. The literature was not critically appraised, and the quality of the evidence from the included reports is unknown.
  • The evidence about the clinical effectiveness of virtual primary care summarized in this report comes from a limited number of studies identified by 3 SRs and was mainly focused on health care utilization outcomes versus patient health or clinical harms outcomes. The findings were mixed, but overall, in-person visits may be associated with lower rates of health care utilization (e.g., emergency department visits, hospitalizations) compared with virtual visits. Virtual consultations may be associated with improved patient engagement compared with in-person care for certain conditions or settings (e.g., opioid addictions) but not others (e.g., smoking cessation, postnatal care, other general settings).
  • The evidence about the cost-effectiveness of virtual primary care summarized in this report comes from 3 studies identified by 1 SR. Virtual primary care compared with in-person care might be cost-effective for patients with asthma and patients who received cognitive behavioural therapy, but these analyses considered very limited outcomes.
  • The evidence about patient and provider experiences and preferences associated with virtual primary care that is summarized in this report comes from 4 SRs. The SRs identified many perceived benefits and drawbacks of virtual primary care from both patient and provider perspectives, including those around access to care, effectiveness, experience and satisfaction, and financial impact and cost.
  • The evidence about potential equity issues associated with virtual primary care summarized in this report comes from 2 SRs. Equity considerations, such as age, may affect individuals accessing and using primary care health services. For example, telephone consultations tended to be used by older individuals (aged ≥ 85 years), while internet-based consultations tended to be used by younger individuals.