• Jodi B Segal, Stacey Davis, and Vadim Dukhanin.
• From Johns Hopkins University School of Medicine, Department of Medicine (JBS); Johns Hopkins Bloomberg School of Public Health, Department of Health Policy and Management (JBS, SD, VD). jsegal@jhmi.edu.
• J Am Board Fam Med. 2022 May 1; 35 (3): 629-633.

BackgroundGiven the absence of guidelines for use of virtual visits for primary care delivery, a framework is needed to inform the most appropriate use of virtual visits.MethodsWe conducted in-depth, structured interviews of 18 patients, primary care clinicians, and other select informants. They were asked to discuss optimal, acceptable, and suboptimal uses of telemedicine for delivering care relative to in-person care delivery. The concepts expressed informed our development of a framework about appropriate use of virtual visits.ResultsThe 103 concepts supported 5 main themes that emerged as a framework: clinical situations which are optimal for in-person care; situations optimal for virtual visits; situations that might be exchangeable between sites; contextual factors favoring in-person care; and contextual factors favoring virtual visits.ConclusionsAfter further validation, we expect that this framework may guide future research and practice: it may be valuable for clinical practice redesign, for designing evaluations of the outcomes of virtual visits, for outcomes research, for patient education, for triage, and possibly for reimbursement considerations.© Copyright 2022 by the American Board of Family Medicine.

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