Short Description: |
Electronic consultation via internet and secure e-mail systems. Electronic care services in different formats (free text consultation, digital triage consultation) of patient-provider interactions were examined. The evaluation concerned interviews with care givers and real-time usage tests of the different systems by care givers and patients. Topics were examined about technology (adaptation and user friendliness of the systems to support self-care), service (responsiveness, feedback, empathy) and organization (incorporation in practice, payment system, health policy regulations).
Several problems were identified while using the systems. Of all the problems patients experienced most were related to self-care support(204/396, 51%), followed by usability problems (165/396, 42%). Caregivers (69/144, 48%) faced relatively more usability problems than patients (96/252, 38%). Caregivers wanted to know how patients acted on their advice but the systems did not offer an adequate feedback facility. Patients faced problems with the navigation and search functionalities, which appeared incapable of handling patients’ health complaints efficiently. Patients expected tailored and personalized information and advice to control their state of health, but the systems failed to deliver this. Caregivers doubted the reliability of the computer-generated information and the efficiency and effectiveness of web-based consultation. Interaction problems were hardly observed by patients (6/252, 2%). Caregivers (21/144, 15%) had problems with the interpretation of patients’ questions posed online.
Conclusions: The most powerful application for self-care is email consultation, combined with a suitable triage mechanism to empower patient’s self-awareness. Future research should focus on the effectiveness of such web-based triage mechanisms for prevention of medical complaints and on the development of interactive functionalities to enhance patient’s self-care. |
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