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. 2019 May 29;20(1):73.
doi: 10.1186/s12875-019-0960-5.

Implementation of web-based hospital specialist consultations to improve quality and expediency of general practitioners' care: a feasibility study

Thomas van der Velden  1 , Bianca W M Schalk  2 , Mirjam Harmsen  3 , Guido Adriaansens  4 , Tjard R Schermer  1 , Marc A Ten Dam  5
Affiliations

Implementation of web-based hospital specialist consultations to improve quality and expediency of general practitioners' care: a feasibility study

Thomas van der Velden et al. BMC Fam Pract. .

Abstract

Background: Rising healthcare costs due to unnecessary referrals to secondary healthcare services underscore the need for optimizing current referral procedures. This study investigates whether the use of web-based consultation (WBC) in general practice is a feasible alternative to decrease referrals.

Methods: Patients with lumbosacral radicular syndrome, knee complaints, or thyroid dysfunction, who visited the general practitioner (GP) between May 2015 and December 2016 were included for a WBC. We determined whether the GP would refer a patient to an outpatient clinic in the absence of a WBC and then compared this decision with the referral advice from a specialist. We further assessed the user-friendliness of the WBC service based on average recorded user time and feedback from the GPs.

Results: Seventy eligible WBCs submitted by GPs were analyzed. Our data showed a 46% absolute reduction in in-persons referrals in our study population. These findings confirmed the feasibility of using WBC. The median time spent to submit a WBC was five and 10 min for GPs and specialists respectively. On average, the WBC service saved €286 per WBC. The results of a questionnaire showed that GPs found WBC to be a user-friendly option which could help reduce the number of in-person referrals.

Conclusion: We demonstrated that WBC is not only feasible but has the potential to reduce nearly half of all in-person referrals to outpatient clinics. WBC decreased healthcare expenses and proved to be a user-friendly and safe alternative to the standard referral process. WBC may potentially have a profound impact on healthcare expenditure if applied in a wider medical setting. For follow-up research, we recommend including a control group for comparative analyses.

Keywords: Feasibility study; General practice; Primary health care; Remote consultation; Telemedicine.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart of the selection of the study population and Web-based consultations between May 2015 and December 2016
See this image and copyright information in PMC

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