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What needs to happen to increase uptake of e-Consult?

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Executive Summary (Full report available on request)

e-Consult is an alternative option for accessing primary care. More than 90% of Devon practices have signed up to e-Consult, yet not everybody uses the platform, which may be due to where they live, their age and their digital literacy skills. 

The research objective was to explore:
“What needs to happen to increase uptake of e-Consult in Devon?”

Research was gathered with over 1,000 patients and professionals across Western Devon.
A total of 1,045 patients completed an open-ended survey and 41 patients and 10 primary health care professionals took part in a depth interview. The depth and breadth of insight findings have been triangulated to provide both prospective and retrospective evidence of what needs to happen to increase e-Consult uptake and consider differences between key patient groups.

What influences patients behaviour?
The COM-B model1 suggests that a persons capability, opportunity and motivation to use e-Consult will influence their choice when accessing primary care. The insight shows that most patients have the capability (necessary skills) to use e-Consult, including many elderly patients who are perceived to be digital illiterate yet have internet access, they simply require support to show them how to use e-Consult.


The opportunity to do an e-Consult is granted to most patients who can access and afford the Internet. Yet the needs of vulnerable patients who don’t have Wi-Fi or the best phone and are at risk of digital exclusion must be considered.

For a patient to choose e-Consult, they must be motivated to use it more than any other competing option, like calling the practice. Busy phone lines have created dissatisfaction with the ‘default option’ to call the practice, and many patients favour e-Consult because its quick and easy, available anywhere, any time and confidential between patient and doctor. Yet many patients, particularly patients with long-term conditions, found e-Consult long-winded and frustrating when they hit a ‘red flag’ and were redirected to acute care. At this point patients have already made a decision that the GP is the best place to go, leading many to ignore the redirection and ‘fudge’ the form to get through or cancel the e-Consult and default to calling the practice.


What support and information do patients need?
Patients need support before they need to access primary care, because it’s more difficult to learn something new when feeling unwell or in pain.  Elderly patients and patients with mental health problems and learning difficulties would benefit from an easy to follow, visual ‘handy guide’ to prepare and guide them through the process. Additionally, practical support and guidance to do an e-Consult from GP practice staff and family/friends would help equip patients with the necessary skills and confidence to complete an e-Consult independently in future.

Participant Reflections:

“More convenient way of getting in touch with doctors, from the comfort of home rather than waiting in a queue. The doctor can call you back already knowing what your issue is”

“The principle is there, but the process of how you access the information and get through it is cumbersome”

“Giving them something beforehand will take away the scariness of it, when people are unsure what it will be like because it’s completely new to them”

“my dad, he still has a brick phone, so you can imagine he wasn’t that willing, but once I sat down with him and we did it together, he was impressed in the end”

To request a copy of the full report please email nina.gavin@icecreates.com or call us on 0845 5193423 

1. Mitchie et al (2011) The behaviour change wheel: A new method for characterising and designing behaviour change interventions

 

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