The large-scale implementation of e-consultations with the GP: a mixed-methods evaluation of the impact on health system, GPs and patients
Description
The aim of this project is to understand under which conditions the use of e-consultations in primary care offers benefits to the health system, GPs and ultimately patients. E-consultations include text-based online consultations, video consultations and telephone consultations.
Goals
Study objectives are defined around three perspectives.
Health system
To study changes in adoption and use of e-consultations in Norway over time (before, during and after the COVID-19 pandemic) and explore the impact on equitable access to care.
General practitioners
To evaluate how GPs perceive clinical appropriateness, safety, quality of communication and role of the doctor-patient relationship in e-consultations. To investigate how different organizational models adopted by GPs affect their workload and availability.
Patients
To evaluate (mirroring GPs’ experience) how patients experience clinical appropriateness, safety, quality of communication and role of the doctor-patient relationship in e-consultations. To investigate the characteristics of users and non-users and the reasons and consequences of using or not using e-consultations.
Method
The project adopts a mixed-methods approach, combining quantitative and qualitative methods to evaluate the large-scale implementation of e-consultations in Norway and address the study objectives.
1. RETROSPECTIVE COHORT STUDY (population data)
A retrospective cohort study will be conducted to explore adoption and use of e-consultations with the GPs before, during and after the COVID-19 pandemic.
2. PROSPECTIVE CROSS-SECTIONAL STUDY (50-100 GPs who use video consultations)
A prospective cross-sectional study will be conducted to evaluate the perspectives of both GPs and patients in association with 1,500 video consultations.
3. PATIENT SURVEY AND INTERVIEWS (users and non-users of e-consultations)
The perspectives of digitally active users and non-users will be explored through an online national survey. In-depth interviews will be conducted with elderly people as a patient group with low digital competence.
Conclusion
This project will provide key stakeholders, policymakers and practitioners with research-generated knowledge on the impact of e-consultations, thus supporting optimal use of the service in routine practice and maximize its benefits.