Patients having online access to medical records and clinicians correlates with an increase in health care utilization, a new study suggests.

Ted E. Palen, MD, PhD, of the Institute for Health Research at Kaiser Permanente Colorado in Denver, and colleagues assessed health care utilization by users and nonusers (aged 18 years and older) of online access to health records before and after initiation of a patient online access system (MyHealthManager [MHM]).

For MHM members versus nonmembers, researchers observed a significant increase in the unadjusted per-member rates of office visits (0.7 per member per year) and telephone encounters (0.3 per member per year), comparing before and after the index date, according to study findings published in the Journal of the American Medical Association (2012;308:2012-2019). For MHM members versus nonmembers, the study found significant increases in the per-1,000-member rates of after-hours clinic visits (18.7 per 1,000 members per year), emergency department encounters (11.2 per 1,000 members per year), and hospitalizations (19.9 per 1,000 members per year).

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“Our findings suggest that the relationship between online access and utilization is more complex than the simple substitution of online for in-person care suggested by earlier studies,” the authors wrote. “As online applications become more widespread, health care delivery systems will need to develop methodologies that effectively integrate health information technologies with in-person care.”