Increasing the use of e-consultation in primary care: Results of an online survey among non-users of e-consultation

Nijland, Nicol; van Gemert-Pijnen, Julia E.W.C.; Boer, Henk; Steehouder, Michaël F.; Seydel, Erwin R.

doi:10.1016/j.ijmedinf.2009.06.002

« Previous Next »International Journal of Medical Informatics
Volume 78, Issue 10 , Pages 688-703, October 2009

Increasing the use of e-consultation in primary care: Results of an online survey among non-users of e-consultation

Nicol Nijland
- Department of Psychology and Communication of Health and Risk, Faculty of Behavioural Sciences, University of Twente, Enschede, The Netherlands
- Corresponding author at: Department of Psychology and Communication of Health and Risk, Faculty of Behavioural Sciences, University of Twente, P.O. Box 217, 7500 AE Enschede, The Netherlands. Tel.: +31 651071559; fax: +31 534894259.
Julia E.W.C. van Gemert-Pijnen
- Department of Psychology and Communication of Health and Risk, Faculty of Behavioural Sciences, University of Twente, Enschede, The Netherlands
Henk Boer
- Department of Psychology and Communication of Health and Risk, Faculty of Behavioural Sciences, University of Twente, Enschede, The Netherlands
Michaël F. Steehouder
- Department of Technical and Professional Communication, Faculty of Behavioural Sciences, University of Twente, Enschede, The Netherlands
Erwin R. Seydel
- Department of Psychology and Communication of Health and Risk, Faculty of Behavioural Sciences, University of Twente, Enschede, The Netherlands

Received 12 February 2009; received in revised form 16 June 2009; accepted 20 June 2009. published online 22 July 2009.

Abstract

Objective

To identify factors that can enhance the use of e-consultation in primary care. We investigated the barriers, demands and motivations regarding e-consultation among patients with no e-consultation experience (non-users).

Methods

We used an online survey to gather data. Via online banners on 26 different websites of patient organizations we recruited primary care patients with chronic complaints, an important target group for e-consultation. A regression analysis was performed to identify the main drivers for e-consultation use among patients with no e-consultation experience.

Results

In total, 1706 patients started to fill out the survey. Of these patients 90% had no prior e-consultation experience. The most prominent reasons for non-use of e-consultation use were: not being aware of the existence of the service, the preference to see a doctor and e-consultation not being provided by a GP. Patients were motivated to use e-consultation, because e-consultation makes it possible to contact a GP at any time and because it enabled patients to ask additional questions after a visit to the doctor. The use of a Web-based triage application for computer-generated advice was popular among patients desiring to determine the need to see a doctor and for purposes of self-care. The patients’ motivations to use e-consultation strongly depended on demands being satisfied such as getting a quick response. When looking at socio-demographic and health-related characteristics it turned out that certain patient groups – the elderly, the less-educated individuals, the chronic medication users and the frequent GP visitors – were more motivated than other patient groups to use e-consultation services, but were also more demanding. The less-educated patients, for example, more strongly demanded instructions regarding e-consultation use than the highly educated patients.

Conclusion

In order to foster the use of e-consultation in primary care both GPs and non-users must be informed about the possibilities and consequences of e-consultation through tailored education and instruction. We must also take into account patient profiles and their specific demands regarding e-consultation. Special attention should be paid to patients who can benefit the most from e-consultation while also facing the greatest chance of being excluded from the service. As health care continues to evolve towards a more patient-centred approach, we expect that patient expectations and demands will be a major force in driving the adoption of e-consultation.

Keywords: Internet, E-mail, Consultation, Patient-provider communication, Primary care