Email communication at the medical primary-secondary care interface: a qualitative exploration.

BACKGROUND: There is little published research into the influence of email communication between primary and secondary care clinicians on patient care. AIM: To explore the use of email communication between clinicians across the primary- secondary care interface, and how this may relate to patient care. DESIGN AND
SETTING: A qualitative study involving primary and secondary care services in the NHS Highland Health Board area, Scotland. Ten GPs and 12 hospital consultants were purposively sampled to reflect diversity.
METHOD: Eligible clinicians were invited to take part in a semi-structured interview. Data were analysed using a thematic analysis approach.
RESULTS: Key themes that emerged for clinicians included general perceptions of email; using email in practice (managing workload, impact on patient journeys, and 'quick answers'); system issues (variability and governance); relational aspects; and email skills.
CONCLUSION: Email communication between primary and secondary care clinicians generally has a positive impact on patient access to specialist expertise. Governance issues around the use of clinical email need to be defined. There may currently be a two-tier health service for those patients (and their GPs) requiring 'quick answers'. © British Journal of General Practice 2016.