eConculta: Impact of Virtual Visits in Primary Care (eConsulta)

• 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. [ Time Frame: 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) ] [ Designated as safety issue: No ]
  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.
  
  

• Measure the doctor/nurse satisfaction [ Time Frame: At the end of the study, 01/12/2010 ] [ Designated as safety issue: No ]

  Satisfaction with the whole service with a 10 point scale. Items:

  1. Are you satisfied with the eConsulta?
  2. It is easy to use the web?
  3. Has it been easy to integrate it with the daily practice?
  
  
• Measure the patient satisfaction [ Time Frame: At the end of the study, 01/12/2010 ] [ Designated as safety issue: No ]

  Satisfaction with the whole service with a 10 point scale. Items:

  1. Are you satisfied with the eConsulta?
  2. It is easy to use the web?
  3. Would you use it in the future?
  
  

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.