Kaiser Permanente analysis compares e-visits with phone, video, in-person care
An online-only e-visit to obtain oral contraceptives resulted in patients picking up their prescriptions more quickly and needing less follow-up than talking to a doctor by phone or video, or seeing a doctor in person, according to a Kaiser Permanente study published in the journal Obstetrics & Gynecology Open.
Kaiser Permanente Northern California (KPNC) has offered the simple online e-visit option for oral contraceptives since 2022 for patient convenience. Patients follow an online process to answer questions about their health before they may receive a prescription for oral contraceptives.
E-visits are an additional way to reduce patient barriers to care, said co-lead author Eve Zaritsky, MD, a gynecologist with The Permanente Medical Group (TPMG). “It is encouraging to see that e-visits provide not just convenience but are also a safe and effective experience for patients seeking prescriptions,” Zaritsky said.
The findings suggest a strong role for telemedicine, and particularly simple e-visits, for contraceptive care, said study co-lead author Dana Sax, MD, MPH, a TPMG emergency medicine physician and research scientist with the Kaiser Permanente Division of Research (DOR). “Improving contraceptive access is an ongoing goal of ours to reduce unintended pregnancies and empower patients.”
The study examined 23,122 medical encounters for contraceptives at KPNC during 2023 and found 14% of the patients used an e-visit, while about half of patients chose to talk to a doctor by phone, 10% by video, and 27% in-person.
E-visits led to more oral contraceptive orders; 92% of patients received a prescription, and e-visit patients had the lowest rate of in-person follow-up with a doctor within a week. Patients picked up their prescriptions fastest with e-visits, on average 9.5 days faster than other visit types.
All the telemedicine visit types had higher rates of prescription contraceptive pickup (telephone 77%, video 76%, e-visit 73%), compared with office visits (62%).
KPNC has adopted an increasing variety of e-visits for straightforward, protocol-driven medical issues such as sexually transmitted disease screening, COVID-19 testing, and bladder infection. E-visits offer flexibility for patients to enter their request or symptoms at off-hour times when a scheduled clinician visit may not be available, or a patient has limited connectivity for a scheduled phone or video visit.
Detailed findings
The average age of those in the study was 28, and they came from varied racial and ethnic backgrounds. Patients aged 35 to 50 were more likely to choose an office visit. Asian, Black, and Hispanic patients were more likely to choose an e-visit over an office visit. Neighborhood socioeconomic status was not associated with a particular type of visit, though those living in more impoverished neighborhoods were less likely to choose video visits.
Those choosing e-visits had the shortest time from initiating care to getting a prescription ordered. Rates of in-person ob/gyn follow-up visits were low across all types of contraceptive visits, though e-visits had lower subsequent appointment rates than telephone and video visits.
“Our findings align with existing research in primary care and women’s health showing that telemedicine can often help patients access clinical care more quickly and conveniently. It can offer patients an extremely efficient way to receive contraception,” said senior author Mary Reed, DrPH, MPH, a DOR research scientist.
The authors suggested additional research to learn reasons for the differences in type of visit seen by race and ethnicity. They also said more needs to be known about improving access to other types of contraception besides oral prescriptions.
The study was funded by the Agency for Healthcare Research and Quality. An abstract from the study was presented at the May 2025 meeting of the American College of Obstetricians and Gynecologists, and won an award for outstanding oral abstract.
Additional co-authors were Jie Huang, PhD, of the Division of Research; and Emily Bolton, DO, Jeitzel M. Torres-Rodriguez, BS, and Ameek K. Bindra, BA, of Kaiser Permanente Medical Center Obstetrics & Gynecology.
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About the Kaiser Permanente Division of Research
The Kaiser Permanente Division of Research conducts, publishes, and disseminates epidemiologic and health services research to improve the health and medical care of Kaiser Permanente members and society at large. KPDOR seeks to understand the determinants of illness and well-being and to improve the quality and cost-effectiveness of health care. Currently, DOR’s 720-plus staff, including 73 research and staff scientists, are working on nearly 630 epidemiological and health services research projects. For more information, visit divisionofresearch.kp.org or follow us @KPDOR.
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