Understanding the use of email consultation in primary care using a retrospective observational study with data of Dutch electronic health records
Open accessAbstract
Objectives: It is unclear why the use of email consultation is not more widespread in Dutch general practice, particularly because, since 2006, its costs can be reimbursed. To encourage further implementation, it is needed to understand the current use of email consultations. This study aims to understand the use of email consultation by different patient groups, compared with other general practice (GP) consultations. Setting: For this retrospective observational study, we used Dutch routine electronic health record data obtained from NIVEL Primary Care Database for the years 2010 and 2014. Participants: 200 general practices were included in 2010 (734 122 registered patients) and 434 in 2014 (1 630 386 registered patients). Primary outcome measures: The number and percentage of email consultations and patient characteristics (age, gender, neighbourhood socioeconomic status and diagnoses) of email consultation users were investigated and compared with those who had a telephone or face-to-face consultation. General practice characteristics were also taken into account. Results: 32.0% of the Dutch general practices had at least one email consultation in 2010, rising to 52.8% in 2014. In 2014, only 0.7% of the GP consultations were by email (the others comprised home visits, telephone and face-to-face consultations). Its use highly varied among general practices. Most email consultations were done for psychological (14.7%); endocrine, metabolic and nutritional (10.9%); and circulatory (10.7%) problems. These diagnosis categories appeared less frequently in telephone and face-to-face consultations. Patients who had an email consultation were older than patients who had a telephone or face-to-face consultation. In contrast, patients with diabetes who had an email consultation were younger. Conclusion: Even though email consultation was done in half the general practices in the Netherlands in 2014, the actual use of it is extremely low. Patients who had an email consultation differ from those who had a telephone or face-to-face consultation. In addition, the use of email consultation by patients is dependent on its provision by GPs.
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There was very little research on e-consultations prior to the pandemic, and findings were limited.
“There was very little research on e-consultations prior to the pandemic, and findings were limited (12, 103–107)”
From Planning and Evaluating Remote Consultation Services: A New Conceptual Framework Incorporating Complexity and Practical Ethics (2021) · cites this paper as [105]
Financial support does not guarantee the large-scale use of eHealth.
“Moreover, financial support does not guarantee the large-scale use of eHealth [32].”
From Lessons Learned From a Living Lab on the Broad Adoption of eHealth in Primary Health Care (2018) · cites this paper as [32]
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- Authors
- Huygens, M. W. J., Swinkels, I. C. S., Verheij, R. A., Friele, R. D., van Schayck, O. C. P., & de Witte, L. P.
- Affiliations
- Maastricht University (NL)
- Netherlands Institute for Health Services Research (NL)
- Tilburg University (NL)
- Center for Care Technology Research, Maastricht, The Netherlands
- Centre for Assistive Technology and Connected Healthcare (CATCH), University of Sheffield, Sheffield, UK
- Corresponding author
- Huygens, Martine W J
- Venue
- BMJ Open
- Publisher
- BMJ
- Published
- 2018-01
- Volume
- 8
- Issue
- 1
- Pages
- e019233
- ISSN
- 2044-6055 (ISSN-L)
- PMC
- PMC5781222
- OpenAlex
- W2785345712
- Cited by
- 24
- References
- 37
- Citations by year
- 2025: 1 · 2024: 2 · 2023: 4 · 2022: 2 · 2021: 8 · 2020: 5 · 2018: 2
- FWCI
- 3.57
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by-nc
- Locations
- BMJ Open (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- Research portal (Tilburg University) (publishedVersion, other-oa)
- PubMed (publishedVersion)
- Research Publications (Maastricht University) (publishedVersion, cc-by-nc)
- White Rose Research Online (University of Leeds, The University of Sheffield, University of York) (acceptedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Research Publications (Maastricht University) (submittedVersion, cc-by-nc)
- Funders
- ZonMw
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Social Sciences › Business, Management and Accounting › Organizational Behavior and Human Resource Management › Healthcare Systems and Technology
- Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
- Keywords
- email consultation, telemedicine, general practice, primary care, telephone consultation, face-to-face consultation, patient characteristics, socioeconomic status, diabetes mellitus, reimbursement
- MeSH terms
- Adolescent, Adult, Aged, Female, House Calls, Humans, Male, Middle Aged, Netherlands, Primary Health Care, Retrospective Studies, Telephone, Patient Satisfaction, Remote Consultation, Electronic Mail, Young Adult, Electronic Health Records, General Practice
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