{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T00:36:17Z","timestamp":1782261377251,"version":"3.54.5"},"reference-count":16,"publisher":"Wiley","issue":"S1","license":[{"start":{"date-parts":[[2024,2,26]],"date-time":"2024-02-26T00:00:00Z","timestamp":1708905600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100006545","name":"National Institute on Minority Health and Health Disparities","doi-asserted-by":"publisher","award":["R01MD016389"],"award-info":[{"award-number":["R01MD016389"]}],"id":[{"id":"10.13039\/100006545","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["R01AG074946"],"award-info":[{"award-number":["R01AG074946"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000133","name":"Agency for Healthcare Research and Quality","doi-asserted-by":"publisher","award":["1K01HS028732\u201001A1"],"award-info":[{"award-number":["1K01HS028732\u201001A1"]}],"id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Learning Health Systems"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Virtual care increased dramatically during the COVID\u201019 pandemic. The specific modality of virtual care (video, audio, eVisits, eConsults, and remote patient monitoring) has important implications for the accessibility and quality of care, but rates of use are relatively unknown. Methods for identifying virtual care modalities, especially in electronic health records (EHR) are inconsistent. This study (a) developed a method to identify virtual care modalities using EHR data and (b) described the distribution of these modalities over a 3\u2010year study period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>EHR data from 316 primary care safety net clinics throughout the study period (4\/1\/2020\u20103\/31\/2023) were included. Visit type (in\u2010person vs virtual) by adults &gt;18\u2009years old were classified. Expert consultation informed the development of two algorithms to classify virtual care visit modalities; these algorithms prioritized different EHR data elements. We conducted descriptive analyses comparing algorithms and the frequency of virtual care modalities.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Agreement between the algorithms was 96.5% for all visits and 89.3% for virtual care visits. The majority of disagreement between the algorithms was among encounters scheduled as audio\u2010only but billed as a video visit. Restricting to visits where the algorithms agreed on visit modality, there were 2\u2010fold more audio\u2010only than video visits.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Visit modality classification varies depending upon which data in the EHR are prioritized. Regardless of which algorithm is utilized, safety net clinics rely on audio\u2010only and video visits to provide care in virtual visits. Elimination of reimbursement for audio visits may exacerbate existing inequities in care for low\u2010income patients.<\/jats:p><\/jats:sec>","DOI":"10.1002\/lrh2.10411","type":"journal-article","created":{"date-parts":[[2024,2,27]],"date-time":"2024-02-27T01:39:58Z","timestamp":1708997998000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Identifying virtual care modality in electronic health record data"],"prefix":"10.1002","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0080-3220","authenticated-orcid":false,"given":"Annie E.","family":"Larson","sequence":"first","affiliation":[{"name":"Research Department OCHIN Inc.  Portland Oregon USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kurt C.","family":"Stange","sequence":"additional","affiliation":[{"name":"Center for Community Health Integration Case Western Reserve University  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Heintzman","sequence":"additional","affiliation":[{"name":"Research Department OCHIN Inc.  Portland Oregon USA"},{"name":"Department of Family Medicine Oregon Health &amp; Science University  Portland Oregon USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yui","family":"Nishiike","sequence":"additional","affiliation":[{"name":"Administrative Office LifeLong Medical Center  Berkeley California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4208-1059","authenticated-orcid":false,"given":"Brenda M.","family":"McGrath","sequence":"additional","affiliation":[{"name":"Research Department OCHIN Inc.  Portland Oregon USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melinda M.","family":"Davis","sequence":"additional","affiliation":[{"name":"Oregon Rural Practice\u2010based Research Network, Department of Family Medicine, OHSU\u2010PSU School of Public Health Oregon Health &amp; Science University  Portland Oregon USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. Marie","family":"Harvey","sequence":"additional","affiliation":[{"name":"College of Public Health and Human Sciences Oregon State University  Corvallis Oregon USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,2,26]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"Centers for Disease Control and Prevention.Telehealth in Rural Communities: How CDC Develops Programs That Deliver Care in New Ways. Altanta GA August 18 2020."},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1377\/forefront.20220713.689213"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-021-07172-y"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.37765\/ajmc.2021.88573"},{"issue":"1","key":"e_1_2_8_6_1","first-page":"1","article-title":"Primary care telemedicine during the COVID\u201019 pandemic: patient's choice of video versus telephone visit","volume":"5","author":"Huang J","year":"2022","journal-title":"Jamia"},{"key":"e_1_2_8_7_1","unstructured":"Office of the National Coordinator for Health Information Technology: Interoperability Standards Advisory. United State Core Data for Interoperability.https:\/\/www.healthit.gov\/isa\/united-states-core-data-interoperability-uscdi#uscdi-v4Accessed September 21 2023."},{"key":"e_1_2_8_8_1","unstructured":"American Medical Association.AMA telehealth policy coding & payment.2023https:\/\/www.ama\u2010assn.org\/practice\u2010management\/digital\/ama\u2010telehealth\u2010policy\u2010coding\u2010payment#:~:text=Nonfacility%20payment%20rates%20for%20telehealth be%20provided%20virtually%20through%202023 Accessed October 5 2023."},{"key":"e_1_2_8_9_1","unstructured":"Services CfMM.List of Telehealth Services.2023https:\/\/www.cms.gov\/medicare\/coverage\/telehealth\/list-servicesAccessed August 15 2023."},{"key":"e_1_2_8_10_1","volume-title":"Uniform Data System 2023 Manual: Health Center Data Reporting Requirements","author":"Bureau of Primary Health Care","year":"2023"},{"key":"e_1_2_8_11_1","volume-title":"Billing for Telehealth Encounters: an Introductory Guide on Fee\u2010for\u2010Service","author":"The Nation Telehealth Policy Resource Center","year":"2023"},{"key":"e_1_2_8_12_1","unstructured":"Health Resources & Services Administration.E\u2010Consults.https:\/\/telehealth.hhs.gov\/providers\/best\u2010practice\u2010guides\/telehealth\u2010for\u2010emergency\u2010departments\/e\u2010consultsAccessed January 2 2024."},{"key":"e_1_2_8_13_1","unstructured":"U.S. Centers for Medicare and Medicaid Services.E\u2010visits.https:\/\/www.medicare.gov\/coverage\/e-visitsAccessed January 2 2024."},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.1307"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.1864"},{"key":"e_1_2_8_16_1","unstructured":"Health Resources & Services Administration.Telehealth policy changes after the COVID\u201019 public health emergency.2023https:\/\/telehealth.hhs.gov\/providers\/telehealth\u2010policy\/policy\u2010changes\u2010after\u2010the\u2010covid\u201019\u2010public\u2010health\u2010emergency#temporary\u2010medicare\u2010changes\u2010through\u2010december\u201031 \u20102024Accessed September 2 2023."},{"key":"e_1_2_8_17_1","unstructured":"MorseS.Aetna to cut coverage for audio\u2010only and asynchronous text\u2010based telehealth visits.2023https:\/\/www.healthcarefinancenews.com\/news\/aetna\u2010cut\u2010coverage\u2010audio\u2010only\u2010and\u2010asynchronous\u2010text\u2010based\u2010telehealth\u2010visitsAccessed October 12 2023."}],"container-title":["Learning Health Systems"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lrh2.10411","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,18]],"date-time":"2024-10-18T13:05:47Z","timestamp":1729256747000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lrh2.10411"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,26]]},"references-count":16,"journal-issue":{"issue":"S1","published-print":{"date-parts":[[2024,6]]}},"alternative-id":["10.1002\/lrh2.10411"],"URL":"https:\/\/doi.org\/10.1002\/lrh2.10411","archive":["Portico"],"relation":{},"ISSN":["2379-6146","2379-6146"],"issn-type":[{"value":"2379-6146","type":"print"},{"value":"2379-6146","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2,26]]},"assertion":[{"value":"2023-10-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-02-09","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-02-26","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e10411"}}