Clinical trial NCT01124968: eConculta: Impact of Virtual Visits in Primary Care
Official title: Before and After Study to Assess the Impact of the Use of Virtual Consultation on Frequency of Patient Attendance, and Satisfaction of Patients and Professionals
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Adult
Keywords: User-Computer Interface
Office Visits
Primary Health Care
Patient Satisfaction
Job Satisfaction
Health Services Research
Lead sponsor: Institut Catala de Salut
Sponsor class: OTHER_GOV
First posted: 2010-05-18
Enrollment: 16720
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: NON_RANDOMIZED
Intervention model: SINGLE_GROUP
Primary purpose: HEALTH_SERVICES_RESEARCH

Brief summary: eConsulta is a before and after quasi-experimental study without control group and its purpose is to asses the impact of virtual visits in primary care on the frequency of attendance of the patients to the primary care centre. The use of virtual consultations should lower the number of face to face visits to primary care. It also should create satisfaction to both users: primary care professionals and patients.

Detailed description: Excess on primary care face to face demands generates a work overload for the professionals, and it could lead to a lower quality of care and less job satisfaction. Not all primary care demands need a face to face encounter so incorporating new technologies into daily practice care such as communication doctor/nurse-patient through a website could be part of the solution. So we designed a study in order to assess the impact of the use of virtual consultation on frequency of attendance and the satisfaction of patients and professionals with the service.

It is a before after quasi-experimental multi-centre study with no control group. Agreed voluntarily to participate 13 primary care centres, 20 primary care physicians, 17 nurses them having 16.720 reference adult patients. We designed a website where participants can access the internet and consult their doctor/nurse, who will answer within 48 hours at maximum. The intervention will last 6 months.

We believe that the site can be useful by both patient and professional. For some types of patient, the use of the site may increase its accessibility, reduce face to face consultations and improve satisfaction, while the professional makes a more efficient practice.

Eligibility criteria: Inclusion Criteria:

* 18 years or over
* having a primary care centre assigned
* to have both physician and nurse participating in the project
* to use the same electronic clinical recording software

Exclusion Criteria:

* none

Primary outcomes:
measure: Number of primary care face to face visits of the patients during the 6 month intervention, compared to the number of face to face visits of the same patient, in a 6 month previous period.
timeFrame: Visits done from 01/06/2010 to 01/12/2010 compared to the himself the same period 1 or 2 years before (depending on the flu)
Secondary outcomes:
measure: Measure the doctor/nurse satisfaction
timeFrame: At the end of the study, 01/12/2010
measure: Measure the patient satisfaction
timeFrame: At the end of the study, 01/12/2010
Other outcomes:
Locations:
city: Barcelona
country: Spain
facility: EAP Gòtic
city: Barcelona
country: Spain
facility: EAP Ramón Turró
city: Barcelona
country: Spain
facility: EAP El Clot
city: Barcelona
country: Spain
facility: EAP Sant Martí
city: Barcelona
country: Spain
facility: EAP La Sagrera
city: Barcelona
country: Spain
facility: EAP Montnegre
city: Barcelona
country: Spain
facility: EAP Sant Andreu
city: Barcelona
country: Spain
facility: EAP El Carmel
city: Barcelona
country: Spain
facility: EAP Horta
city: Barcelona
country: Spain
facility: EAP Pare Claret
city: Barcelona
country: Spain
facility: EAP Dr. Carles Ribas
city: Barcelona
country: Spain
facility: EAP Congrés
city: Barcelona
country: Spain
facility: EAP Guinardó Baix
Study officials:
affiliation: Institut Català de la Salut
name: Josep Casajuana
role: PRINCIPAL_INVESTIGATOR
affiliation: Institut Català de la Salut
name: Maria A Casas
role: STUDY_CHAIR
affiliation: Institut Català de la Salut
name: Rosa Chumillas
role: STUDY_CHAIR
affiliation: Institut Català de la Salut
name: Mireia Fàbregas
role: STUDY_CHAIR
affiliation: Institut Català de la Salut
name: Ana I Garaikoetxea
role: STUDY_CHAIR
affiliation: Institut Català de la Salut
name: Maria I Garrido
role: STUDY_CHAIR
affiliation: Institut Català de la Salut
name: Yolanda Lejardi
role: STUDY_CHAIR
affiliation: Institut Català de la Salut
name: María J Martínez
role: STUDY_CHAIR
affiliation: Institut Català de la Salut
name: Maria C Piorno
role: STUDY_CHAIR
affiliation: Institut Català de la Salut
name: Joan Camús
role: STUDY_CHAIR
References:
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citation: Weiss N. E-mail consultation: clinical, financial, legal, and ethical implications. Surg Neurol. 2004 May;61(5):455-9; discussion 459. doi: 10.1016/j.surneu.2003.09.029.
citation: Leong SL, Gingrich D, Lewis PR, Mauger DT, George JH. Enhancing doctor-patient communication using email: a pilot study. J Am Board Fam Pract. 2005 May-Jun;18(3):180-8. doi: 10.3122/jabfm.18.3.180.
citation: Messikomer CM. "Our options have changed. .. we will not call you back". Communicating with my primary care physician. Perspect Biol Med. 2007 Summer;50(3):435-43. doi: 10.1353/pbm.2007.0035.
citation: Roter DL, Larson S, Sands DZ, Ford DE, Houston T. Can e-mail messages between patients and physicians be patient-centered? Health Commun. 2008;23(1):80-6. doi: 10.1080/10410230701807295.
citation: Kjaer NK, Jepsen KL, Ruwald S, Jepsen NP, Nielsen HH. [E-mail communication in general practice]. Ugeskr Laeger. 2005 Nov 21;167(47):4461-5. Danish.
citation: Kuszler PC. A question of duty: common law legal issues resulting from physician response to unsolicited patient email inquiries. J Med Internet Res. 2000 Jul-Sep;2(3):E17. doi: 10.2196/jmir.2.3.e17. No abstract available.
citation: Bovi AM; Council on Ethical and Judicial Affairs of the American Medical Association. Ethical guidelines for use of electronic mail between patients and physicians. Am J Bioeth. 2003 Summer;3(3):W-IF2. doi: 10.1162/152651603322874771.