Intended for healthcare professionals

Letters E-consultations

Online access to GPs can offer benefits to GPs and patients

BMJ 2017; 359 doi: https://doi.org/10.1136/bmj.j5769 (Published 20 December 2017) Cite this as: BMJ 2017;359:j5769
  1. Stephen Black, data scientist
  1. Black Box Data Science, Biggleswade SG18 0QA, UK
  1. steve.i.black{at}gmail.com

The BMJ reports a study that found online consultations increase workload for general practitioners (GPs).1 But we shouldn’t write off the benefits of electronic consultation tools for either GPs or patients on the basis of a study of a single system that achieved very low rates of use.

Some alternatives to eConsult have very different philosophies. eConsult and some competitors use complex algorithms to supplement GP expertise. Patients don’t like this as they have to answer many questions, and it often fails to give a clear diagnosis.

What really matters for online consultations is improving the speed of patient access and the ability of GPs to respond quickly. Often only 30-40% of patients need a 10 minute appointment. Identifying this group can lead to major savings in GP time if many of the remaining cases are resolved online or in a short phone call. With the online consultation tool askmyGP, patients usually get a response from the GP on the same day, the majority in less than two hours. This is far better than standard appointment booking systems, which often make patients wait days or weeks for a face to face slot and typically reject about 10-15% of requests because no appointment slots are available.

Online systems like askmyGP won’t work for every patient. But they can work for a large proportion. Because the system makes access faster and GPs more efficient, the benefits accrue to the patients who don’t use it as well as to those who do.

It is early days for online GP access. The goals of faster access and more efficient GPs can be met if the developers of the systems learn from experience and adapt their systems accordingly. It is misleading to write off the whole idea as a failure on the basis of a small study of a single system.

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