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. 2018 May 2;15(5):896.
doi: 10.3390/ijerph15050896.

Evaluation of a Digital Consultation and Self-Care Advice Tool in Primary Care: A Multi-Methods Study

Julie Cowie  1 , Eileen Calveley  2 , Gillian Bowers  3 , John Bowers  4
Affiliations

Evaluation of a Digital Consultation and Self-Care Advice Tool in Primary Care: A Multi-Methods Study

Julie Cowie et al. Int J Environ Res Public Health. .

Abstract

Digital services are often regarded as a solution to the growing demands on primary care services. Provision of a tool offering advice to support self-management as well as the ability to digitally consult with a General Practitioner (GP) has the potential to alleviate some of the pressure on primary care. This paper reports on a Phase II, 6-month evaluation of eConsult, a web-based triage and consultation system that was piloted across 11 GP practices across Scotland. Through a multi-method approach the evaluation explored eConsult use across practices, exposing both barriers and facilitators to its adoption. Findings suggest that expectations that eConsult would offer an additional and alternative method of accessing GP services were largely met. However, there is less certainty that it has fulfilled expectations of promoting self-help. In addition, low uptake meant that evaluation of current effectiveness was difficult for practices to quantify. The presence of an eConsult champion(s) within the practice was seen to be a significant factor in ensuring successful integration of the tool. A lack of patient and staff engagement, insufficient support and lack of protocols around processes were seen as barriers to its success.

Keywords: digital health; implementation; primary care; self-management.

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Conflict of interest statement

The authors declare no conflict of interest. The founding sponsors had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, and in the decision to publish the results.

Figures

Figure 1
Figure 1
Simplified eConsult process.
Figure 2
Figure 2
Comparison of eConsult site visits with eConsults submitted (April–August 2017).
Figure 3
Figure 3
Estimated annual eConsult site visits and submissions per 1000 patients (age > 18 years *). * estimated number of patients aged 18+ from Information Services Division (ISD) count of patients aged 15–24 [20].
Figure 4
Figure 4
Percentage of eConsults submitted by gender 17 September–18 January.
Figure 5
Figure 5
Comparison of the percentage of patients aged 18–64 with those aged over 65 years.
Figure 6
Figure 6
Comparison of the relative age distribution of patients aged over 18 with the age distribution of eConsult users in the trial practices (excluding P04, P06 and P07).
Figure 7
Figure 7
Comparison of the percentage of the eConsult submissions from patients aged 18–44 with the percentage of adult patients in that age group in the trial practices (excluding P04, P06 and P07).
Figure 8
Figure 8
eConsult submission rates versus percentage of patients in the most deprived quintiles.
Figure 9
Figure 9
eConsult submission rates versus percentage of patients in the most affluent quintiles.
Figure 10
Figure 10
The number of eConsults /patient required versus % of consultations saved for breakeven.
Figure 11
Figure 11
eConsult submission rates required for breakeven at a cost of £1 per patient.
See this image and copyright information in PMC

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