GP Online: turning expectations into reality with the new NHS app

Beaney, Paul; Odulaja, Anjolaoluwa; Hadley, Andy; Prince, Clive B; Chambers, Ruth

doi:10.3399/bjgp19x701333

Cited by 7 publications

(6 citation statements)

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“…OCs are considered by policy makers in many countries as a way to address the increasing workload and decreasing workforce capacity in primary care [31][32][33][34][35][36] while still meeting patient expectations and improving access [37]. However, they have the potential to exacerbate health inequities [38,39] and increase inappropriate antibiotic prescriptions [40].…”

Section: Introductionmentioning

confidence: 99%

Understanding How the Design and Implementation of Online Consultations Affect Primary Care Quality: Systematic Review of Evidence With Recommendations for Designers, Providers, and Researchers

Darley¹,

Coulson²,

Peek³

et al. 2022

J Med Internet Res

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Background Online consultations (OCs) allow patients to contact their care providers on the web. Worldwide, OCs have been rolled out in primary care rapidly owing to policy initiatives and COVID-19. There is a lack of evidence regarding how OC design and implementation influence care quality. Objective We aimed to synthesize research on the impacts of OCs on primary care quality, and how these are influenced by system design and implementation. Methods We searched databases from January 2010 to February 2022. We included quantitative and qualitative studies of real-world OC use in primary care. Quantitative data were transformed into qualitative themes. We used thematic synthesis informed by the Institute of Medicine domains of health care quality, and framework analysis informed by the nonadoption, abandonment, scale-up, spread, and sustainability framework. Strength of evidence was judged using the GRADE-CERQual approach. Results We synthesized 63 studies from 9 countries covering 31 OC systems, 14 (22%) of which used artificial intelligence; 41% (26/63) of studies were published from 2020 onward, and 17% (11/63) were published after the COVID-19 pandemic. There was no quantitative evidence for negative impacts of OCs on patient safety, and qualitative studies suggested varied perceptions of their safety. Some participants believed OCs improved safety, particularly when patients could describe their queries using free text. Staff workload decreased when sufficient resources were allocated to implement OCs and patients used them for simple problems or could describe their queries using free text. Staff workload increased when OCs were not integrated with other software or organizational workflows and patients used them for complex queries. OC systems that required patients to describe their queries using multiple-choice questionnaires increased workload for patients and staff. Health costs decreased when patients used OCs for simple queries and increased when patients used them for complex queries. Patients using OCs were more likely to be female, younger, and native speakers, with higher socioeconomic status. OCs increased primary care access for patients with mental health conditions, verbal communication difficulties, and barriers to attending in-person appointments. Access also increased by providing a timely response to patients’ queries. Patient satisfaction increased when using OCs owing to better primary care access, although it decreased when using multiple-choice questionnaire formats. Conclusions This is the first theoretically informed synthesis of research on OCs in primary care and includes studies conducted during the COVID-19 pandemic. It contributes new knowledge that, in addition to having positive impacts on care quality such as increased access, OCs also have negative impacts such as increased workload. Negative impacts can be mitigated through appropriate OC system design (eg, free text format), incorporation of advanced technologies (eg, artificial intelligence), and integration into technical infrastructure (eg, software) and organizational workflows (eg, timely responses). Trial Registration PROSPERO CRD42020191802; https://tinyurl.com/2p84ezjy

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Section: Introductionmentioning

confidence: 99%

Understanding How the Design and Implementation of Online Consultations Affect Primary Care Quality: Systematic Review of Evidence With Recommendations for Designers, Providers, and Researchers

Darley¹,

Coulson²,

Peek³

et al. 2022

J Med Internet Res

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show abstract

“…19 In 2019, the National Health Service (NHS) application was introduced to contrast the slow progress in widescale adoption of these services and provide a better solution to patients. 20 Through the NHS application, citizens can now identify themselves through the national Citizen Identity tool and use additional facilities, including a symptom checker and access to donor information. 20 Some private providers are also offering access to GP consultations via mobile or online triage platforms, including askmyGP, eConsult and Egton Online Triage.…”

Section: Introductionmentioning

confidence: 99%

“…20 Through the NHS application, citizens can now identify themselves through the national Citizen Identity tool and use additional facilities, including a symptom checker and access to donor information. 20 Some private providers are also offering access to GP consultations via mobile or online triage platforms, including askmyGP, eConsult and Egton Online Triage. 20 21 Such forms of electronic communication have been considered by patients as equivalent or better than face-to-face contacts 22 and represent an appropriate and potentially cost-saving addition to in-person delivery of primary care.…”

Section: Introductionmentioning

confidence: 99%

Patients’ use and experiences with e-consultation and other digital health services with their general practitioner in Norway: results from an online survey

Zanaboni

Fagerlund

2020

BMJ Open

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ObjectivesTo explore patients’ use and experiences with four digital health services implemented in Norway to enable electronic communication between patients and their general practitioner (GP): (1) electronic booking of appointments; (2) electronic prescription renewal; (3) electronic contact with the GP’s office for non-clinical inquiries; and (4) e-consultation for clinical inquiries.DesignAn online survey consisting of quantitative data supplemented by qualitative information was conducted to explore: (1) characteristics of the users; (2) use; (3) experiences, perceived benefits and satisfaction; and (4) time spent using the digital health services.SettingPrimary care.Participants2043 users of the digital health services answering the survey.ResultsThere was a higher proportion of women, younger adults and digitally active citizens with high education. Electronic booking of appointments was the most used service (66.4%), followed by electronic prescription renewal (54.3%). Most users (80%) could more easily and efficiently book an appointment electronically than by phone. Over 90% of the respondents thought that it was easier to renew a prescription electronically, 76% obtained a better overview of their medications and 46% reported higher compliance. For non-clinical inquiries, most respondents (60%) thought that it was easier to write electronic messages than communicate by phone. For clinical enquiries, many patients agreed that e-consultation could lead to a better followup (72%) and improved quality of treatment (58%). Users were highly satisfied with the services and recommended their use to others. Time saving was the most evident benefit for patients. This was confirmed by the differences in time spent using the digital health services compared with conventional approaches, all found to be statistically significant.ConclusionCitizens using e-consultation and other digital health services with their GP in Norway are satisfied and consider them as useful and efficient alternatives to conventional approaches.

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“…The majority of the participants displayed awareness regarding data privacy, but it was one of the least expressed concerns. Among users of the NHS app, this response was majorly due to trust in services provided by the NHS, therefore, suggesting the influence of product branding which was demonstrated as one of the strengths of the NHS app by Beaney et al [48]. The lack of concern was also influenced by participants perception of the level of sensitivity of their medical information within their portal.…”

Section: Discussionmentioning

confidence: 96%

Evaluation of experiences and attitudes of patients towards patient portal enabled access to their health information or medical records – A Qualitative Study

Kuppanda

Jenkins

2022

Preprint

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The demand for patient centred care and patient engagement in their healthcare has driven patient portal introduction. The widespread adoption and use of patient portals, however, has been a rather slow process in the United Kingdom (UK). Hence, a limited number of studies have explored patient perceptions and experiences of general portal use which forms a foundation for successful implementation of a portal. This study, therefore, focuses on the experiences and attitudes of patients regarding use of patient portals and access to their health information. It further explores various factors perceived by patients that may influence portal use and uptake. These patient experiences were gathered through semi-structured interviews of 13 participants and the data collected was subjected to analysis using the grounded theory approach. The overall findings from this study highlights positive patient perceptions of portal use. Nevertheless, it demonstrates various areas of improvement essential to ensure successful implementation and acceptance of patient portals in the future.

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GP Online: turning expectations into reality with the new NHS app

Cited by 7 publications

References 1 publication

Understanding How the Design and Implementation of Online Consultations Affect Primary Care Quality: Systematic Review of Evidence With Recommendations for Designers, Providers, and Researchers

Understanding How the Design and Implementation of Online Consultations Affect Primary Care Quality: Systematic Review of Evidence With Recommendations for Designers, Providers, and Researchers

Patients’ use and experiences with e-consultation and other digital health services with their general practitioner in Norway: results from an online survey

Evaluation of experiences and attitudes of patients towards patient portal enabled access to their health information or medical records – A Qualitative Study

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