In recent years, general practices have been increasingly using digital healthcare, especially since the COVID-19 pandemic. Digital healthcare can help to guarantee the quality of general practice care, despite the increasing pressure on the sector. In practice, however, general practitioners (GPs) find that digital healthcare often leads to increased workloads and inequality in access. Good integration into existing work processes and sufficient user support are therefore essential for the successful adoption of digital healthcare in general practice. This is evident from the doctoral research conducted by Jelle Keuper at Nivel. He obtained his PhD from Tilburg University on 30 January.
More digital care and increased workload
General practitioners (GPs) find that digital healthcare often leads to extra workload, especially in the start-up phase and when applications do not fit well with existing work processes. GPs also experienced this at the start of the COVID-19 pandemic, when the implementation and use of digital healthcare, such as digital communication (e-consultations, video consultations, teleconsultations) and (online access to) the patient portal, increased significantly in almost all practices. After the initial phase of the pandemic, the use of most digital healthcare applications increased less rapidly, and the use of video consultations declined.
Efficiency and equity under pressure
Research shows that digital healthcare can help to guarantee the quality of general practice care, despite increasing pressure, but there are also risks. Not only does it often fail to increase efficiency, it can also increase inequality in access to general practice care. For example, vulnerable patient groups, who use more healthcare services, are less likely to have the necessary digital skills and were less likely to give consent for electronic health information exchange in the period 2017-2019. Therefore, more attention needs to be paid to proper integration into existing workflows, user-friendly applications and support for both healthcare providers and patients.
Want to know more?
For the results of this Nivel research, read the entire publication.
About the study
The doctoral thesis was conducted at Nivel, in collaboration with Tilburg University. The research consisted of a systematic literature review on the impact of the use of digital healthcare applications on the workload in general practice care (2010-2020), an analysis of data from the Nivel Primary Care Database on factors associated with consent for electronic health information exchange (2017-2019), a web survey via the Nivel General Practitioner Practice Survey and interviews with GPs about their experiences with the use of digital healthcare applications during the COVID-19 pandemic, and an analysis of national monitoring data on the adoption of video consultations. The Dutch Healthcare Authority and the Ministry of Health, Welfare and Sport funded three sub-studies.
