Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Dec 31;16(12):e76690.
doi: 10.7759/cureus.76690. eCollection 2024 Dec.

Use of Internet/Application-Based E-consults by General Practitioners in Japan to Resolve Patients' Problems: A Descriptive Observational Study

Taku Harada  1   2 , Toru Morikawa  3   4 , Hiroki Furuya  5 , Tomoki Sato  6 , Minami Kakehi  7 , Hiroki Yamada  8 , Taro Shimizu  2
Affiliations

Use of Internet/Application-Based E-consults by General Practitioners in Japan to Resolve Patients' Problems: A Descriptive Observational Study

Taku Harada et al. Cureus. .

Abstract

Introduction Electronic consultations (e-consults) refer to digital health technologies that enhance clinical information sharing and improve patients' access to expert healthcare providers. This study aims to describe the current utilization of the Internet/application-based e-consult system and to assess how effectively it resolves clinical questions. Methods Participants were general practitioners (GPs) who had installed the e-consult platform on their personal computers or cell phones. Hospital specialists who responded to the e-consults were previously registered on our e-consult platform and also participated in the study. We have developed and implemented an Internet/application-based e-consult system that GPs can use on their personal computers in Japan. In this descriptive study, GPs used the e-consult platform via an Internet/application to consult hospital specialists. The study period was from May 1, 2020, to October 31, 2021. The outcome measure was the resolution rate, calculated by dividing the number of cases resolved solely through e-consults by the total number of e-consult cases. Another outcome measure was the number of cases in which a plan was determined using e-consults. Other outcome measures were GP satisfaction, assessed using a 5-point Likert scale for e-consults, the number of chats required for a hospital specialist to respond, and the time from the GP's initial question to the hospital specialist's first response. Results Of the 329 e-consult cases identified, 91 conducted by GPs were included in the final analysis. The number of cases resolved using only e-consults was 47, resulting in a resolution rate of 52% in the study. The minor specialists exhibited the highest resolution rate using e-consults alone. The number of cases where a plan was determined using e-consults was 83, accounting for 91% of the total 91 cases. The level of GP satisfaction with the e-consult process was high, with a median satisfaction score of 5 on a 5-point Likert scale. Most e-consults received their initial response within two hours. The number of chats required for hospital specialists to respond was very low, with a median of only one chat being necessary. Conclusion The Internet/application-based e-consult system enabled GPs to address a wide range of medical problems. Further studies with large samples are necessary, even though these results serve as an important benchmark for future research on e-consults in Japan.

Keywords: application; digital health technology; e-consult; general practitioner; internal medicine; internet.

PubMed Disclaimer

Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Ethical review board of Showa University Koto Toyosu Hospital issued approval 21-070-A. This study was approved by the ethical review board of Showa University Koto Toyosu Hospital (approval number: 21-070-A) and was conducted in accordance with the Declaration of Helsinki . Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: F.H., S.T., S.T., and K.M. have received consulting fees from Medii, Inc., and Y.H. is a CEO of Medii, Inc. T.H., M.T., and S.T. did not receive any form of support or gifts, such as research funding, consulting fees, honoraria, royalties, license fees, or travel/transportation expenses. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Flow chart of the study
Figure 2
Figure 2. Rate in which a plan for the patient was determined by e-consults alone
Figure 3
Figure 3. Resolution rate by e-consults alone
Figure 4
Figure 4. The actual interface of our internet/application-based e-consult system
Figure 5
Figure 5. The conceptual visual design of our internet/application-based e-consult system
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Electronic consultation in primary care between providers and patients: systematic review. Mold F, Hendy J, Lai YL, de Lusignan S. https://medinform.jmir.org/2019/4/e13042 JMIR Med Inform. 2019;7:0. - PMC - PubMed
    1. Electronic consultations (e-consults) to improve access to specialty care: a systematic review and narrative synthesis. Vimalananda VG, Gupte G, Seraj SM, Orlander J, Berlowitz D, Fincke BG, Simon SR. https://journals.sagepub.com/doi/full/10.1177/1357633X15582108. J Telemed Telecare. 2015;21:323–330. - PMC - PubMed
    1. Los Angeles safety-net program eConsult system was rapidly adopted and decreased wait times to see specialists. Barnett ML, Yee HF Jr, Mehrotra A, Giboney P. https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2016.1283. Health Aff (Millwood) 2017;36:492–499. - PubMed
    1. Los Angeles safety-net program eConsult system was rapidly adopted and decreased wait times to see specialists. Ahmed S, Kelly YP, Behera TR, et al. https://www.acpjournals.org/doi/abs/10.7326/m19-3852. Ann Intern Med. 2020;172:641–647. - PubMed
    1. Providing specialty consultant expertise to primary care: an expanding spectrum of modalities. Kirsh SR, Ho PM, Aron DC. https://www.sciencedirect.com/science/article/abs/pii/S0025619614003772. Mayo Clin Proc. 2014;89:1416–1426. - PubMed

LinkOut - more resources