BIROn - Birkbeck Institutional Research Online

    Electronic consultation in primary care between providers and patients: systematic review

    Mold, F. and Hendy, J. and Lai, Yi-Ling and de Lusignan, S. (2019) Electronic consultation in primary care between providers and patients: systematic review. Journal of Medical Internet Research 7 (4), ISSN 2291-9694.

    [img]
    Preview
    Text
    JMIR YL Published.pdf - Published Version of Record
    Available under License Creative Commons Attribution.

    Download (256kB) | Preview

    Abstract

    Background: Governments and health care providers are keen to find innovative ways to deliver care more efficiently. Interest in electronic consultation (e-consultation) has grown, but the evidence of benefit is uncertain. Objective: This study aimed to assess the evidence of delivering e-consultation using secure email and messaging or video links in primary care. Methods: A systematic review was conducted on the use and application of e-consultations in primary care. We searched 7 international databases (MEDLINE, EMBASE, CINAHL, Cochrane Library, PsycINFO, EconLit, and Web of Science; 1999-2017), identifying 52 relevant studies. Papers were screened against a detailed inclusion and exclusion criteria. Independent dual data extraction was conducted and assessed for quality. The resulting evidence was synthesized using thematic analysis. Results: This review included 57 studies from a range of countries, mainly the United States (n=30) and the United Kingdom (n=13). There were disparities in uptake and utilization toward more use by younger, employed adults. Patient responses to e-consultation were mixed. Patients reported satisfaction with services and improved self-care, communication, and engagement with clinicians. Evidence for the acceptability and ease of use was strong, especially for those with long-term conditions and patients located in remote regions. However, patients were concerned about the privacy and security of their data. For primary health care staff, e-consultation delivers challenges around time management, having the correct technological infrastructure, whether it offers a comparable standard of clinical quality, and whether it improves health outcomes. Conclusions: E-consultations may improve aspects of care delivery, but the small scale of many of the studies and low adoption rates leave unanswered questions about usage, quality, cost, and sustainability. We need to improve e-consultation implementation, demonstrate how e-consultations will not increase disparities in access, provide better reassurance to patients about privacy, and incorporate e-consultation as part of a manageable clinical workflow.

    Metadata

    Item Type: Article
    Keyword(s) / Subject(s): referral and consultation, health services accessibility, primary health care, general practice, patient access to records, patient portals, Web-based access
    School: School of Business, Economics & Informatics > Organizational Psychology
    Depositing User: Yi-Ling Lai
    Date Deposited: 27 May 2020 10:22
    Last Modified: 09 Feb 2021 14:40
    URI: https://eprints.bbk.ac.uk/id/eprint/31995

    Statistics

    Downloads
    Activity Overview
    48Downloads
    31Hits

    Additional statistics are available via IRStats2.

    Archive Staff Only (login required)

    Edit/View Item Edit/View Item