A survey of GP attitudes to and experiences of email consultations

Neville, Ron; Marsden, Wendy; McCowan, Colin; Pagliari, Claudia; Mullen, Helen; Fannin, Allison

doi:10.14236/jhi.v12i4.127

Cited by 27 publications

(21 citation statements)

References 3 publications

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“…Generally, email and web-messaging created new and increased volumes of contacts,62 81 105 106 108 126 132 137 though four studies reported no change 88 94 120 138. Telephone contact appeared to rise and fall back when new services were offered,71 106 though six studies reported no change in telephone volume,88 94 97 101 102 126 and three reported a rise 33 108 136…”

Section: Resultsmentioning

confidence: 99%

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Patients’ online access to their electronic health records and linked online services: a systematic interpretative review

et al. 2014

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ObjectivesTo investigate the effect of providing patients online access to their electronic health record (EHR) and linked transactional services on the provision, quality and safety of healthcare. The objectives are also to identify and understand: barriers and facilitators for providing online access to their records and services for primary care workers; and their association with organisational/IT system issues.SettingPrimary care.ParticipantsA total of 143 studies were included. 17 were experimental in design and subject to risk of bias assessment, which is reported in a separate paper. Detailed inclusion and exclusion criteria have also been published elsewhere in the protocol.Primary and secondary outcome measuresOur primary outcome measure was change in quality or safety as a result of implementation or utilisation of online records/transactional services.ResultsNo studies reported changes in health outcomes; though eight detected medication errors and seven reported improved uptake of preventative care. Professional concerns over privacy were reported in 14 studies. 18 studies reported concern over potential increased workload; with some showing an increase workload in email or online messaging; telephone contact remaining unchanged, and face-to face contact staying the same or falling. Owing to heterogeneity in reporting overall workload change was hard to predict. 10 studies reported how online access offered convenience, primarily for more advantaged patients, who were largely highly satisfied with the process when clinician responses were prompt.ConclusionsPatient online access and services offer increased convenience and satisfaction. However, professionals were concerned about impact on workload and risk to privacy. Studies correcting medication errors may improve patient safety. There may need to be a redesign of the business process to engage health professionals in online access and of the EHR to make it friendlier and provide equity of access to a wider group of patients.A1. Systematic review registration numberPROSPERO CRD42012003091.

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Section: Resultsmentioning

confidence: 99%

“…Several studies (n=16) also highlighted clinicians’ concerns about privacy and confidentiality 43 51 58 67 77 82 – 84 98 105 111 121 138 146–148. Patients in one study expressed willingness to trade-off security for ease of access 115.…”

Section: Resultsmentioning

confidence: 99%

Patients’ online access to their electronic health records and linked online services: a systematic interpretative review

et al. 2014

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“…33,34 Given that nearly three-quarters of U.S. adults currently report e-mail or internet access, 35 the low rate of physician-patient e-mail communication suggests a lack of appropriate clinical infrastructure rather than lack of patient access. 36,37 Low use may also reflect negative attitudes, resistance, and/or inertia among physicians. Consumer surveys have found that up to 70% of Internet users would engage in e-mail communication with their physicians if given the opportunity.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of basic information technology use by U.S. physicians

Grant

Campbell²,

Gruen

et al. 2006

J Gen Intern Med

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BACKGROUND: Information technology (IT) has been advocated as an important means to improve the practice of clinical medicine. OBJECTIVES: To determine current prevalence of non‐electronic health record (EHR) IT use by a national sample of U.S. physicians, and to identify associated physician, practice, and patient panel characteristics. DESIGN, SETTING, AND PARTICIPANTS: Survey conducted in early 2004 of 1,662 U.S. physicians engaged in direct patient care selected from 3 primary care specialties (family practice, internal medicine, pediatrics) and 3 nonprimary care specialties (anesthesiology, general surgery, cardiology). MEASUREMENTS: Self‐reported frequency of e‐mail communication with patients or other clinicians, online access to continuing medical education or professional journals, and use of any computerized decision support (CDS) during clinical care. Survey results were weighted by specialty and linked via practice zip codes to measures of area income and urbanization. RESULTS: Response rate was 52.5%. Respondents spent 49 (±19) (mean [±standard deviation]) hours per week in direct patient care and graduated from medical school 23 (±11) years earlier. “Frequent” use was highest for CDS (40.8%) and online professional journal access (39.0%), and lowest for e‐mail communication with patients (3.4%). Ten percent of physicians never used any of the 5 IT tools. In separate logistic regression analyses predicting usage of each of the 5 IT tools, the strongest associations with IT use were primary care practice (adjusted odds ratios [aORs] ranging from 1.34 to 2.26) and academic practice setting (aORs 2.17 to 5.41). Years since medical school graduation (aOR 0.85 to 0.87 for every 5 years after graduation) and solo/2‐person practice setting (aORs 0.21 to 0.55) were negatively associated with IT use. Practice location and patient panel characteristics were not independently associated with IT use. CONCLUSIONS: In early 2004, the majority of physicians did not regularly use basic, inexpensive, and widely available IT tools in clinical practice. Efforts to increase the use of IT in medicine should focus on practice‐level barriers to adoption.

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“…11,[25][26][27] The authors consulted with 32 GPs and 20 physiotherapists via brief surveys and discussions at professional development events. Over 200 primary care patients of all ages were consulted on their views using the following methods: electronic surveys to GP patient panels, discussions at patient consultation meetings, and surveys undertaken by school-aged children among their peers.…”

Section: Define the Scope Of The Reviewmentioning

confidence: 99%