The Impact of Digital-First Consultations on Workload in General Practice: Modeling Study

Area of Science:

• Health Services Research
• Primary Care Medicine
• Digital Health

Background:

• Many countries are adopting digital-first models for general practice access.
• These models offer online, video, or telephone consultations before face-to-face appointments.
• Claims suggest improved patient access and moderated doctor workload, but potential workload increases exist.

Purpose of the Study:

• To investigate if and under what conditions digital-first access to general practice impacts workload.
• To explore the circumstances under which workload may decrease or increase.

Main Methods:

• Developed a process map for primary care access pathways.
• Constructed a Microsoft Excel model to estimate general practice workload.
• Conducted a systematic literature review (MEDLINE, 2000-2019) for quantitative data on digital consultations.
• Extracted key variables including consultation type, duration, and new demand proportion.

Main Results:

• Digital-first approaches are likely to increase general practice workload.
• Online, telephone, and video consultations may increase workload by 25%, 3%, and 31% respectively in base-case scenarios.
• The impact on workload depends significantly on consultation length and the proportion of patients managed without follow-up.

Conclusions:

• Digital-first primary care models may increase general practice workload unless specific conditions are met.
• Justification for these models should rely on evidence of benefits versus costs, not assumed workload reductions.
• Implementation should be staged with careful evaluation due to potential workload increases and access issues.