[Both patients and physicians benefit from internet-based communication (APIKAP study)]

Abstract

Background: Internet-based applications are becoming more common in our modern world. While electronic health records (EHR) are available for patients and health care providers outside of Germany, most of the available data on EHR address only monetary advantages.This study explores whether or not internet-based communication between family physicians (FP) and patients is as safe as traditional oral communication and if it may lead to further benefits.

Methods: 500 patients from 14 family doctors' offices were included in this 6 months RCT. Both groups were treated in the same manner by their respective physicians, but members of the study group (SG) were able to access an individual developed web-based software where they could view their diagnosis and medication, and send an electronic message to their doctors who would respond. Their satisfication with the FP, certain health data and the FP's workload were recorded.

Results: a) Patients' satisfaction: When e.g. asked about the organization of the family practice or trust in the doctor, there were no significant differences between the control (CG) and the SG (p = 0.07; p = 0.53). However, patients of the SG felt better informed (p = 0.01), and generally more satisfied with their FP (p = 0.04). b) FP workload: Members of the CG had 8.44 contacts with their doctors during the study, while the SG only had 7.96 recorded contacts (including web-based contacts, p = 0.32). It took physicians 3:52 minutes less to read and respond to an electronic message than to see a patient during the consultation hours. c) Changes in patients' health: During the study the blood pressure (BP) in the CG rose 4.44/2.80 mmHg, while it dropped 3.13/4.36 mmHg in the SG (p = 0.19/0.01).The HbA(1C) dropped in both groups (p = 0.91). One week after the first visit to the family doctor, patients of the SG rated their pain 0.28 points lower on a VAS than the CG (p = 0.75). 91% from the CG and 96% from the SG requested the re-prescription of long-term medication on time (p = 0.16).

Conclusions: Using an optional web-based communication platform is as safe as traditional consultations can be. Both patients and doctors may benefit from using the internet in this context.