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Evaluation of eConsult use by Defence Primary Healthcare primary care clinicians using a mixed-method approach
  1. Antony Sean Willman
  1. Academic Department of General Practice, RCDM, Birmingham, UK
  1. Correspondence to Dr Antony Sean Willman, Academic Department of General Practice, RCDM, Birmingham B15 2SQ, UK; aswillman{at}mac.com

Abstract

Introduction eConsult has recently been introduced into Defence Primary Healthcare to allow Service Personnel of the British Armed Forces and their dependants improved access to healthcare. This review sought the views of primary care clinicians using eConsult.

Method An 18-item survey was constructed after an initial scoping survey. This was then distributed to primary care clinicians in Defence Primary Healthcare to assess the broader applicability of the themes identified. Data synthesis of this alongside free-text responses from respondents was undertaken to explore advantages and disadvantages of eConsult.

Results Four themes were identified: accessibility, effects on working practices, impact on the dynamics of the consultation and training/administrative support. eConsult did not save time for clinicians but was generally more convenient for patients. eConsult was often used in conjunction with telephone and face-to-face follow-up, forming a ‘blended consultation’. Accessibility was improved, but cultural factors may affect some patients engaging.

Conclusions eConsult improves accessibility for patients but does not reduce workload. It should be used alongside conventional access methods, not instead of. It was found to be useful for straightforward clinical and administrative problems but less useful for more complex cases unless part of a ‘blended consultation’. Future use could be modified to provide greater data gathering for occupational health and chronic disease monitoring and should be monitored to ensure it is inclusive of all demographic groups.

  • primary care
  • change management
  • organisational development

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Footnotes

  • Twitter @antonywillman

  • Collaborators Kate King and Matthew Boulter.

  • Contributors Peer review and advice was provided by Col M Smith L/RAMC (Defence Professor of General Practice and Primary Care), Surg Cdr K King RN (Senior Lecturer in General Practice) and Lt Col Matthew Boulter TD RAMC (Senior Lecturer in General Practice).

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval As this was a service evaluation, ethical approval was not required.

  • Data availability statement Data are available on reasonable request. All original data are held on secure REDCap servers in the University of Birmingham. It is available on request from the Academic Department of Military General Practice & Primary Care.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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