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.
Highlights
Across the United Kingdom (UK), the continued increase in patients requiring a GeneralPractitioner (GP) consultation for non-urgent conditions is putting enormous strain on practices, with excessive demand for appointments and increased patient dissatisfaction with the service [1].The situation is unlikely to improve with an increasingly elderly population worldwide, who are both living longer and with multi-morbidities [2].Strategy documents such as the Modern Outpatient [3] advocate for a new model in care provision, where, given appropriate tools and resources, individuals are encouraged to take responsibility for their own health and well-being, adopting a self-management model
The key aims of the evaluation as agreed with the Scottish Government were to examine the impact of eConsult on patients; the impact of eConsult on the General Practitioner (GP) surgery and its staff; the time implications of eConsult; the cost/effectiveness of eConsult use; and identify barriers and facilitators to future implementation
Eleven GP practices across four Scottish National Health Service (NHS) boards participated in the evaluation
Summary
The situation is unlikely to improve with an increasingly elderly population worldwide, who are both living longer and with multi-morbidities [2] Strategy documents such as the Modern Outpatient [3] advocate for a new model in care provision, where, given appropriate tools and resources, individuals are encouraged to take responsibility for their own health and well-being, adopting a self-management model. Such a shift in the balance of care attempts to promote wellness and in turn, reduce interactions with health care services [4]. One area that has received much attention is the use of eHealth, in relation to use of websites and/or apps providing information on aspects such as illness trajectories, symptoms, and treatments relating to specific conditions [5,6]
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