eConculta: Impact of Virtual Visits in Primary Care

Adult Clinical Trial

— eConsulta  

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

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT01124968
• Other study ID #: eConsulta
• Status: Completed
• Phase: N/A
• First received: May 11, 2010
• Last updated: February 7, 2011
• Start date: January 2009
• Est. completion date: December 2010

Study information

• Verified date: January 2011
• Source: Institut Catala de Salut
• Contact: n/a
• Is FDA regulated: No
• Health authority: Spain: Comité Ético de Investigación Clínica de l'IDIAP Jordi Gol
• Study type: Interventional

Clinical Trial 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.

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.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 16720
• Est. completion date: December 2010
• Est. primary completion date: December 2010
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: Both
• Age group: 18 Years and older

Eligibility

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:

Study Design

Allocation: Non-Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Health Services Research

Related Conditions & MeSH terms

• Adult

Intervention

Other:
• eConsulta
It is a web specifically designed for the project where elected patients can consult virtually with their primary care physician and within 48 hours have an answer.

Locations

Country	Name	City	State
Spain	EAP Congrés	Barcelona
Spain	EAP Dr. Carles Ribas	Barcelona
Spain	EAP El Carmel	Barcelona
Spain	EAP El Clot	Barcelona
Spain	EAP Gòtic	Barcelona
Spain	EAP Guinardó Baix	Barcelona
Spain	EAP Horta	Barcelona
Spain	EAP La Sagrera	Barcelona
Spain	EAP Montnegre	Barcelona
Spain	EAP Pare Claret	Barcelona
Spain	EAP Ramón Turró	Barcelona
Spain	EAP Sant Andreu	Barcelona
Spain	EAP Sant Martí	Barcelona

Sponsors (1)

Lead Sponsor	Collaborator
Institut Catala de Salut

Country where clinical trial is conducted

Spain, 

References & Publications (8)

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. — View 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. — View 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. — View 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. — View 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. — View 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. — View Citation

Spielberg AR. On call and online: sociohistorical, legal, and ethical implications of e-mail for the patient-physician relationship. JAMA. 1998 Oct 21;280(15):1353-9. — View Citation

Weiss N. E-mail consultation: clinical, financial, legal, and ethical implications. Surg Neurol. 2004 May;61(5):455-9; discussion 459. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	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.	Number of face to face visits of each patient (who used the eConsulta web site) to primary care physician or nurse during the 6 months of the intervention (from 01/06/2010 to 01/12/2010) compared to the number of visits of the same patients the same period 1 or 2 years before, depending on the appearance of a swine flu outbreak (2009 if there is a swine flu outbreak or 2008 if there is not). The information source of the number of visits will be the electronic clinical record, which is the same in all the practices participating.	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)	No
Secondary	Measure the doctor/nurse satisfaction	Satisfaction with the whole service with a 10 point scale. Items: Are you satisfied with the eConsulta?; It is easy to use the web?; Has it been easy to integrate it with the daily practice?	At the end of the study, 01/12/2010	No
Secondary	Measure the patient satisfaction	Satisfaction with the whole service with a 10 point scale. Items: Are you satisfied with the eConsulta?; It is easy to use the web?; Would you use it in the future?	At the end of the study, 01/12/2010	No

External Links

•   eConsulta