A service user evaluation of eConsult use by Defence Primary Healthcare Primary Care Clinicians using a mixed-method approach.

Willman, A.

Introduction eConsult has been recently introduced into Defence Primary Healthcare to allow patients electronic access to healthcare. Using mixed methods, this service evaluation sought the views of primary care clinicians using eConsult. Methods A two-phase sequential exploratory mixed-method approach was used. An inductive thematic analysis of feedback from primary care clinicians in the Salisbury Plain Area identified themes around eConsult use. These were used to construct an 18-item survey instrument. This was then distributed to primary care clinicians in Defence Primary Healthcare to assess the broader applicability of the themes. Results Four themes were identified: the impact on accessibility, the effects on working practices, the impact on the dynamics of the consultation and the effect of training and 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 consult. Accessibility was improved, but cultural factors may affect some patients engaging. Conclusions eConsult improves accessibility and can reduce telephone and face to face consultations but does not reduce workload. It should be used alongside conventional access methods, not instead of. It is useful for straightforward clinical and administrative problems but is less useful for more complex cases unless part of a blended consult. 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.