Older patients’ experiences of access to and use of e-consultations with the general practitioner in Norway: an interview study

Abstract

Objective

To explore older patients’ experiences with accessing and using e-consultations to send text-based clinical inquiries to the general practitioner (GP) online.

Design

Qualitative study based on semi-structured interviews. Results were analysed through a six-phase thematic analysis and interpreted through Levesque’s framework of patient-centred access to health care.

Setting

General practice in Norway.

Subjects

Patients aged over 65 years (n = 16) with experience in using e-consultations.

Results

Respondents considered e-consultations as an integrated part of general practice which helped them achieve better access to health care. We identified four themes describing older patients’ access to and use of e-consultations: 1) the importance of digital health literacy to learn about and use the service – and the fear of losing it, 2) the high availability of the service as the main advantage, due to the perceived unavailability of physical GP services, 3) the importance of voluntary use of e-consultations, 4) the importance of a trusting relationship with the GP.

Implications

Information about e-consultations and guidelines for suitable use are recommended to ensure equal access to all patients, regardless of their digital health literacy. Availability problems and high work burdens for the GPs could affect the patients’ choice for using e-consultations. If e-consultations are used for triage purposes, caution should be taken to avoid a shift in workload from the health secretary to the GP.

Key points of article

• The extended use of e-consultations with the general practitioner has raised concerns that the service may not be accessible and suitable for older patients.

• For older users, e-consultations can represent a positive addition to physical consultation forms due to the high availability of the service in a general practice setting characterised by long waiting times.

• Digital health literacy is essential to learn about and use the service. Information about the service and how to use it should be available to all patients to ensure equal access.

• A trusting relationship with the GP is described as essential for older patients to perceive the outcome of e-consultations as appropriate and safe.

Keywords:

• E-health
• e-consultation
• general practice
• qualitative research
• older patients
• access

Correction Statement

This article has been corrected with minor changes. These changes do not impact the academic content of the article.

Acknowledgements

The authors thank all participants in the study and the Pensioners’ Association for helping to promote the study.

Ethical approval

All respondents gave their verbal consent to participate in the study and were informed of their right to withdraw. The study and the procedure for handling the data were approved by the Data Protection Officer of the University Hospital of North Norway (#02820). According to the Norwegian Act on Medical and Health Research §2 and §4, the study did not require approval from the ethics committee.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1 Only combined statistics for video consultations, telephone consultations and text-based e-consultations are available.

2 The average number of consultations with a GP per year per patient is three in Norway.

Additional information

Funding

This study was funded by the Norwegian Research Council (project no. 315404).