Evaluation of eConsult use by Defence Primary Healthcare primary care clinicians using a mixed-method approach.

INTRODUCTION: eConsult has recently been introduced into Defence Primary Healthcare to allow Service Personnel of the British Armed Forces and their dependants improved access to healthcare. This review sought the views of primary care clinicians using eConsult.
METHOD: An 18-item survey was constructed after an initial scoping survey. This was then distributed to primary care clinicians in Defence Primary Healthcare to assess the broader applicability of the themes identified. Data synthesis of this alongside free-text responses from respondents was undertaken to explore advantages and disadvantages of eConsult.
RESULTS: Four themes were identified: accessibility, effects on working practices, impact on the dynamics of the consultation and training/administrative support. eConsult did not save time for clinicians but was generally more convenient for patients. eConsult was often used in conjunction with telephone and face-to-face follow-up, forming a 'blended consultation'. Accessibility was improved, but cultural factors may affect some patients engaging.
CONCLUSIONS: eConsult improves accessibility for patients but does not reduce workload. It should be used alongside conventional access methods, not instead of. It was found to be useful for straightforward clinical and administrative problems but less useful for more complex cases unless part of a 'blended consultation'. Future use could be modified to provide greater data gathering for occupational health and chronic disease monitoring and should be monitored to ensure it is inclusive of all demographic groups. © Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.