“Get Used to the Fact That Some of the Care Is Really Going to Take Place in a Different Way”: General Practitioners’ Experiences with E-Health during the COVID-19 Pandemic

Meurs, M.; Keuper, J.; Sankatsing, Valérie D.V.; Batenburg, Ronald; Tuyl, Lilian H D van

doi:10.3390/ijerph19095120

Cited by 15 publications

(10 citation statements)

References 24 publications

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“…Many GPs and practice staff view and experience the technologically mediated video consultation as constraining their ability to provide high-quality health care to patients. This is due to technological challenges (eg, poor broadband) [ 26 ], impaired sensory and semiotic opportunities to read body language (in comparison with face-to-face encounters), and the diminished opportunities that a video consultation provides for being the health professional that they want to be [ 16 , 25 ]. It should thus be recognized that these barriers do not only relate to the individual settings but to wider issues in general practice pertaining to professionalism, identity, and integrity that the medium itself is perceived to challenge.…”

Section: Focused Action On Understanding Cultural Barriers Is Requiredmentioning

confidence: 99%

Low Adoption of Video Consultations in Post–COVID-19 General Practice in Northern Europe: Barriers to Use and Potential Action Points

Hvidt¹,

Atherton²,

Keuper³

et al. 2023

J Med Internet Res

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In the wake of the COVID-19 pandemic, video consultation was introduced in general practice in many countries around the world as a solution to provide remote health care to patients. It was assumed that video consultation would find widespread adoption in post–COVID-19 general practice. However, adoption rates remain low across countries in Northern Europe, suggesting that barriers to its use exist among general practitioners and other practice staff. In this viewpoint, we take a comparative approach, reflecting on similarities and differences in implementation conditions of video consultations in 5 Northern European countries’ general practice settings that might have created barriers to its use within general practice. We convened at a cross-disciplinary seminar in May 2022 with researchers and clinicians from 5 Northern European countries with expertise in digital care in general practice, and this viewpoint emerged out of dialogues from that seminar. We have reflected on barriers across general practice settings in our countries, such as lacking technological and financial support for general practitioners, that we feel are critical for adoption of video consultation in the coming years. Furthermore, there is a need to further investigate the contribution of cultural elements, such as professional norms and values, to adoption. This viewpoint may inform policy work to ensure that a sustainable level of video consultation use can be reached in the future, one that reflects the reality of general practice settings rather than policy optimism.

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Section: Focused Action On Understanding Cultural Barriers Is Requiredmentioning

confidence: 99%

Low Adoption of Video Consultations in Post–COVID-19 General Practice in Northern Europe: Barriers to Use and Potential Action Points

Hvidt¹,

Atherton²,

Keuper³

et al. 2023

J Med Internet Res

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“…However, the wider implementation has also shown good examples, where for instance, telemedicine helped the deprived gain access to care (48). Keys to successful scaleup relate to the user-friendliness of the application, structural integration of telemedicine in the primary care organisation supported by the right nancial mechanisms (49). An important observation in both Slovenia and Belgium was that the current way of nancing PHC system is not t for these changes that were necessary in crises situations and that allow better integrated chronic care.…”

Section: Discussionmentioning

confidence: 99%

Lessons on integrated chronic care organisation of primary care during the COVID-19 pandemic: case study analyses in Cambodia, Slovenia, and Belgium

Danhieux,

Martens,

Chhim

et al. 2023

Preprint

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Background During the COVID-19 pandemic, people living with Noncommunicable diseases (NCDs) were at double risk: developing severe COVID-19 and developing complications from not having their chronic condition(s) well controlled. Primary Health Care (PHC) is paramount for integrated care of chronic diseases, but was severely restrained during the pandemic. Our aim was to examine how the organisation of PHC for chronic diseases was affected by the pandemic, and as such, shine a light on strengths, weaknesses, and opportunities in different types of health systems. Methods Semi-structured interviews with 69 participants were carried out in three countries with different primary health care systems: a developing health system in a lower middle-income country (Cambodia); a centrally steered health system in a high-income country (Slovenia); and a publicly funded highly privatised health-care health system in a high-income country (Belgium). Both PHC providers and macro-level stakeholders were interviewed by the international team. An inductive thematic analysis was performed. Results In all three countries the workload of the staff was high and shifted towards pandemic related tasks, affecting availability for chronic care. It also created space for innovations such as telemedicine. In general, recognition of the importance of PHC increased. But also considerable differences between the three countries’ health care systems have been uncovered. In Cambodia medicines are lacking but a strong civil servant ethos is present. In Slovenia strong leadership appeared to be an important strength, but flexibility of PHC workers was limited. This flexibility and entrepreneurship turned out to be valuable in Belgium, but there fragmentation of PHC was a barrier. Conclusions Moments of crisis and disruption lay bare the structural agility and gaps more clearly, as a magnifying glass. In Cambodia, there is a need to sustainable supply of medicines. In Slovenia, the shortage of general practitioners (GPs) needs attention. In Belgium, rethinking of the PHC practice organisation is needed. Our analyses provide the opportunity to analyze and build back stronger health care systems.

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“…Especially in the lockdown period in the winter of 2021 in the Netherlands, Homelab was used more than that in the other months. However, the shift to web-based health care possibly remains because the benefits of using eHealth are more well-known now, and patients have a more positive attitude toward eHealth now than before the COVID-19 period [34,35]. Second, data were unavailable on whether patients really used the diagnostic test package that they ordered.…”

Section: Limitations and Strengths Of This Studymentioning

confidence: 99%

The Usability of Homelab, a Digital Self-service at a Dutch General Practice, for Diagnostic Tests: Pilot Study With a Questionnaire

Schnoor¹,

Versluis²,

Chavannes³

et al. 2023

JMIR Form Res

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Background eHealth potentially can make health care more accessible and efficient and help reduce the workload in primary health care. Homelab is an eHealth tool implemented in a general practice environment, and it offers relatively simple laboratory diagnostic tests without the referral of the general practitioner. After logging in this eHealth tool, patients select and order a diagnostic test based on their symptoms. The test results are presented online to the general practitioner and the patient. Objective This study aims to evaluate the use, usability, and user characteristics of Homelab. Further, it aims to evaluate whether Homelab replaces an appointment with the general practitioner. Methods Homelab has been implemented since May 2021 as a pilot in a Dutch general practice. The number of requests and the ordered diagnostic packages are monitored. After using Homelab, patients are invited to complete a short questionnaire. The questionnaire contains demographic questions and assesses usability using the System Usability Scale (10 items). In addition, questions about requesting an appointment with the general practitioner without Homelab are included. All data were anonymous. Results The questionnaire was filled by 74 individual patients. The mean age of the patients was 40.33 (SD 12.11) years, and half of them were females (39/74, 53%). The majority of the patients were highly educated (56/74, 76%) and employed (53/74, 72%). Approximately 81% (60/74) of the patients reported that they would use Homelab again in the future and 66% (49/74) reported that they would have gone to the general practitioner if they had not used Homelab. The usability of Homelab was perceived higher by the younger age group (mean 73.96, SD 14.74) than by the older age group (mean 61.59, SD 14.37). In total, 106 test packages were ordered over 1 year, and the most requested diagnostic package was “Am I still healthy? I want to do my annual health checkup.” Homelab was used the most during the months of the COVID-19 lockdown. Conclusions The use of Homelab, a digital self-service for ordering diagnostic tests, was monitored in this study, and its usability was perceived as above average. Our findings showed that patients are willing to use Homelab in the future and they would use it most of the time as a replacement for regular consultations. Homelab offers opportunities for more accessible and efficient health care for both the patient and the general practitioner.

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“Get Used to the Fact That Some of the Care Is Really Going to Take Place in a Different Way”: General Practitioners’ Experiences with E-Health during the COVID-19 Pandemic

Cited by 15 publications

References 24 publications

Low Adoption of Video Consultations in Post–COVID-19 General Practice in Northern Europe: Barriers to Use and Potential Action Points

Low Adoption of Video Consultations in Post–COVID-19 General Practice in Northern Europe: Barriers to Use and Potential Action Points

Lessons on integrated chronic care organisation of primary care during the COVID-19 pandemic: case study analyses in Cambodia, Slovenia, and Belgium

The Usability of Homelab, a Digital Self-service at a Dutch General Practice, for Diagnostic Tests: Pilot Study With a Questionnaire

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