Expectations and experiences of eHealth in primary care: A qualitative practice-based investigation

• Published in: International journal of medical informatics (Shannon, Ireland) Vol. 78; no. 9; pp. 588 - 604
• Main Authors: Flynn, Donal, Gregory, Peggy, Makki, Hani, Gabbay, Mark
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier Ireland Ltd 01.09.2009
• Subjects: Attitude of Health Personnel; Communication; Computerized medical record; eHealth; Evaluation; Information Dissemination - methods; Information technology; Internal Medicine; Internet; Other; Patient Education as Topic - statistics & numerical data; Patient Satisfaction - statistics & numerical data; Primary care; Primary Health Care - statistics & numerical data; Public Health Informatics - methods; Quality Assurance, Health Care; United Kingdom; Evaluation; Computerized medical record; Internet; Information technology; Primary care; eHealth; Communication
• ISSN: 1386-5056; 1872-8243
• DOI: 10.1016/j.ijmedinf.2009.03.008

Abstract Objectives (1) To assess expectations and experiences of a new eHealth service by patients and staff in three primary care settings; (2) to ascertain attitudes to a range of future, primary care-oriented eHealth services. Design Qualitative case study. Setting Three UK general practices introducing an eHealth service for booking patient appointments. Participants Ninety patients purposively selected from users and non-users of the new service and 28 staff (clinicians, management and administrative staff). Results Actual patient use of the service was lower than stated intention. Patients and staff felt that more active promotion of the service would have resulted in more use. Low usage did not result in a negative assessment of the service by most staff. Different patient groupings were identified with characteristics that may be used as predictors of eHealth service use and indicators of training needs. GPs and patients expressed opposing viewpoints on a range of future eHealth services. Conclusions Take-up of eHealth services may be lower than expected. To overcome patient barriers, factors that may narrow the intention–behaviour gap such as level of service promotion, GP endorsement, and usage by different patient groups, should be investigated. For clinician barriers, the eHealth evidence base needs strengthening, while for primary care practices, a learning process including staff training needs to be instituted. The differing views of patients and GPs about components of eHealth means that policymakers need to plan for a lengthy political process to obtain agreement on contentious issues if they are to achieve successful eHealth services.