Turner, A, Morris, R, Rakhra, D et al. (12 more authors) (2022) Unintended consequences of online consultations: a qualitative study in UK primary care. British Journal of General Practice, 72 (715). e128-e137. ISSN 0960-1643
Abstract
Background: Health services are increasingly using digital tools to deliver care and online consultations are being widely adopted in primary care settings. The intended consequences of online consultations are to increase patient access to care and increase the efficiency of care. Aim: To identify and understand the unintended consequences of online consultations in primary care. Design and Setting: Qualitative interview study in eight general practices using online consultation tools in South West and North West England. Method: Thematic analysis of semi-structured interviews with 19 patients and 18 general practice staff. Results: We identified consequences of online consultations that restricted patient access to care by making it difficult for some patients to communicate effectively with a GP and disadvantaging digitally-excluded patients. This stemmed from patient uncertainty about how their queries were dealt with and whether practices used online consultations as their preferred method for patients to contact the practice. We identified consequences that limited increases in practice efficiency by creating additional work, isolation and dissatisfaction for some staff. Conclusion: Unintended consequences often present operational challenges that are foreseeable and partly preventable. However these challenges must be recognised and solutions resourced sufficiently. Not everyone may benefit and local decisions will need to be made about trade-offs. Bespoke process change is critical to making effective use of online consultation tools. Unintended consequences also present clinical challenges that result from asynchronous communication. Online consultation tools favour simple, well-formulated, information exchange that leads to diffuse relationships and a more transactional style of medicine.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Keywords: | Online consultations; Unintended consequences; Digital first primary care; Digital health |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Education, Social Sciences and Law (Leeds) > School of Sociology and Social Policy (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 02 Nov 2021 12:16 |
Last Modified: | 22 Jul 2022 10:28 |
Status: | Published |
Publisher: | Royal College of General Practitioners |
Identification Number: | 10.3399/bjgp.2021.0426 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:179656 |