Understanding the use of email consultation in primary care using a retrospective observational study with data of Dutch electronic health records

M.W.J. Huygens, I.C.S. Swinkels, R.A. Verheij, R. Friele, O.C.P. van Schayck, L.P. de Witte

Research output: Contribution to journalArticleScientificpeer-review

7 Citations (Scopus)

Abstract

Objectives:
It is unclear why the use of email consultation is not more widespread in Dutch general practice, particularly because, since 2006, its costs can
be reimbursed. To encourage further implementation, it is needed to understand the current use of email consultations. This study aims to understand the use of email consultation by different patient groups, compared with other general practice (GP) consultations.

Setting:
For this retrospective observational study, we used Dutch routine electronic health record data obtained from NIVEL Primary Care Database for the
years 2010 and 2014.

Participants:
200 general practices were included in 2010 (734 122 registered patients) and 434 in 2014 (1 630 386 registered patients).

Primary outcome measures:
The number and percentage of email consultations and patient characteristics (age, gender, neighbourhood socioeconomic status and diagnoses) of email consultation users were investigated and compared with those who had a telephone or face-to-face consultation. General practice characteristics were also taken into account.

Results:
32.0% of the Dutch general practices had at least one email consultation in 2010, rising to 52.8% in 2014. In 2014, only 0.7% of the GP consultations were by email (the others comprised home visits, telephone and face-to-face consultations). Its use highly varied among general practices. Most email consultations were done for psychological (14.7%); endocrine, metabolic and nutritional (10.9%); and circulatory (10.7%) problems. These diagnosis categories appeared less frequently in telephone and face-to-face consultations. Patients who had an email consultation were older than patients who had a telephone or face-to-face consultation. In contrast, patients with diabetes who had an email consultation were younger.

Conclusion:
Even though email consultation was done in half the general practices in the Netherlands in 2014, the actual use of it is extremely low. Patients who had an email consultation differ from those who had a telephone or face-to-face consultation. In addition, the use of email consultation by patients is dependent on its provision by GPs.
Original languageEnglish
Article numbere019233
Number of pages10
JournalBMJ Open
Volume8
Issue number1
DOIs
Publication statusPublished - 2018

Keywords

  • Adolescent
  • Adult
  • Aged
  • Electronic Health Records
  • Electronic Mail
  • Female
  • General Practice/statistics & numerical data
  • House Calls
  • Humans
  • Male
  • Middle Aged
  • Netherlands
  • Patient Satisfaction/statistics & numerical data
  • Primary Health Care/organization & administration
  • Remote Consultation/methods
  • Retrospective Studies
  • Telephone
  • Young Adult

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