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Implementing online consultations in primary care: a mixed-method evaluation extending normalisation process theory
Michelle Farr1,2, Jonathan Banks1,2, Hannah B Edwards1,2
1Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
BMJ Open
|March 21, 2018
Summary
Patient and staff experiences with UK primary care online consultations varied, with high patient satisfaction but concerns about duplicated workload and communication. Improvements in co-implementation are needed for efficiency.
Area of Science:
- Digital Health
- Primary Care Technology
- Health Services Research
Background:
- Online consultation systems are increasingly adopted in primary care.
- Understanding patient and staff perspectives is crucial for effective implementation.
- Evaluating the co-production of e-consultations informs system development.
Purpose of the Study:
- To examine patient and staff views on a UK primary care online consultation system.
- To assess the acceptability and experiences with the e-consultation system.
- To identify areas for improvement in system design and implementation.
Main Methods:
- A mixed-method evaluation was conducted in UK primary care practices.
- Qualitative interviews with practice staff and patient surveys were analyzed.
- Patient record data and free-text comments were used to assess usage and outcomes.
Main Results:
- Patient and staff expectations for e-consultation use differed significantly.
- Most e-consultations led to further appointments, increasing GP workload.
- Patient satisfaction was high, though some reported communication issues.
Conclusions:
- E-consultation systems are 'co-implemented' by patients and staff.
- The current system improves access for some but lacks perceived efficiency for practices.
- Mapping co-production touchpoints can guide e-consultation system improvements.
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