Experiences of using email for general practice consultations: a qualitative study
Experiences of using email for general practice consultations: a qualitative study
复制标题
DOI：
10.3399/bjgp13x674440
复制
发表时间：
2013-11-01
影响因子：
5.9
通讯作者：
Murray, Elizabeth
中科院分区：
文献类型：
--
作者：
Atherton, Helen;Pappas, Yannis;Murray, Elizabeth
背景报告显示，英国约有21-23%的全科医生使用电子邮件与患者进行咨询，但人们对这种使用的性质以及它对临床医生和患者在一般实践中的意义知之甚少。目的通过调查现有用户的经验和专家的意见，了解电子邮件咨询在一般实践中的使用情况。设计和环境2010年进行的一项定性研究，采用有目的抽样和半结构化访谈，在伦敦一些行政区的一般实践和社区环境中进行。方法选取全科医生和使用电子邮件进行全科咨询的患者，以及政策和/或实施专家作为最大变异样本。采访继续进行，直到达到饱和状态。结果共访谈10名全科医生、14名患者和6名专家。电子邮件咨询往往是由后勤或实际问题引发的；继续使用的动机是对全科医生和患者的便利等好处。全科医生和患者都表示担心电子邮件咨询的安全性，以及缺乏关于“交战规则”的指导，全科医生还担心工作量。作为回应，两个组织都试图引入自己的规则，尽管这只能在一定程度上解决不确定性。长期来看，与会者认为有必要进行监管和指导。结论在一般实践中，通过电子邮件进行咨询是一种不规范和非结构化的方式。目前英国的政策是通过电子邮件促进咨询，这使得考虑临床医生面临的责任和工作量以及确保安全使用所需的变化变得至关重要；如果不这样做，可能会有违反安全规定的风险，并导致对患者的护理不够理想。
Background Reports suggest approximately 21-23% of GPs in the UK have consulted with patients using email, but little is known about the nature of this use and what it means for clinicians and patients in general practice.AimTo understand the use of email consultation in general practice by investigating the experiences of existing users and views of experts.Design and settingA qualitative study conducted in 2010 using purposive sampling and semi-structured interviews in general practice and community settings in some London boroughs.MethodA maximum variation sample of GPs and patients who had used email for consultation in general practice were recruited, as were policy and/or implementation experts. Interviews continued until saturation was achieved. Results In total 10 GPs, 14 patients, and six experts were interviewed. Consultation by email was often triggered by logistic or practical issues; motivators for ongoing use were the benefits, such as convenience, for GPs and patients. Both GPs and patients reported concerns about safety and lack of guidance about the 'rules of engagement' in email consultations, with GPs also concerned about workload. In response, both groups attempted to introduce their own rules, although this only went some way to addressing uncertainty. Long term, participants felt there was a need for regulation and guidance.ConclusionConsultations by email in general practice occur in an unregulated and unstructured way. Current UK policy is to promote consultations by email, making it crucial to consider the responsibility and workload faced by clinicians, and the changes required to ensure safe use; not doing so may risk safety breaches and result in suboptimal care for patients.