by Aman Kundraw

eConsult – Your Questions Answered

Do you have questions or concerns about online consulting? You may find the answers here.

Whether you’re a GP practice that’s sceptical about implementing yet another piece of software, or a CCG that wants to understand how to choose the right online consulting tool for your area, our frequently asked questions may help.

I’m considering online consulting solutions. Why should I choose eConsult?

If you’re looking for an online consulting solution that was designed by clinicians who understand primary care, and who built a product to meet those challenges, eConsult is for you. eConsult provides online triage and self-help options which ensure that many patients will not choose to book an appointment with their GP. But we also enable GPs to optimise their day by providing asynchronous consultation that meets patients’ needs, while freeing-up time for more complicated cases.

Is it just a webcam?

eConsult is not a form of webcam offering patients another way to consult with their GP face-to-face. We believe that webcam would not offer any time savings for GPs at scale, and there are also concerns that the IT infrastructure in practice could not support widespread use of webcam or Skype consultations. eConsults are dynamic questionnaire sets that patients complete online, in their own time, and that their GP will see and respond to within one working day.

eConsults give the patient the chance to think about their symptoms and respond to a list of questions that will give their GP all the information he or she needs to make a considered diagnosis and prescribe effective treatment. Unlike a webcam or Skype consultation, eConsults save GPs’ time – each one takes around two-to-three minutes to process, compared with a ten-minute face-to-face appointment.

Won’t it simply increase supply-led demand?

In today’s time-poor society, most people are looking for speedy answers to their problems – few want to wait for several days and take time off work to visit their GP practice. By giving patients the resources they need to help themselves, eConsult helps reduce the need for face-to-face or telephone consultations. In our pilot study, 97% of patients who used eConsult said they would have requested either a face-to-face or telephone appointment with their GP or gone to a walk-in centre or A&E had the service not existed.

Will online consulting just open up another channel into the practice?

Far from being a kind of primary care slot machine, electronic consulting offers patients an alternative way to consult with their own GP, and it offers GPs a more effective, time-efficient way of helping patients. It doesn’t open up a two-way channel that GPs have no way of controlling (like, for example, email), and in the majority of cases an eConsult will obviate the need for a face-to-face consultation.

Won’t we be excluding core users with this solution?

We shouldn’t make assumptions that the over-65s are not embracing the internet. Silver surfers have the biggest uptake rates of technology nationally, and people over the age of 65 make up 25% of eConsult users in an average month. It is also unlikely that less affluent people will be excluded from this form of consultation – most people have access to smart phones and tablets, which enables them to use the internet.

Does it change my indemnity?

The major medical defence organisations consider eConsult as part of normal working, and therefore within the existing parameters of clinical risk (like, say, a telephone consultation). So GPs using the service will not experience any change in premiums or indemnity.

What about patients for whom English is not their first language?

When a practice has patients whose first language isn’t English, an interpreter is required for face-to-face consultations, which can be costly and complicated to set up. With eConsult, the patient can ask their own advocate (often a friend or a family member) to help them with the online form – someone who can support them to complete the eConsult in their own time. During our pilot study in Tower Hamlets, London, where a high proportion of patients are from a BME background, patients told us this was a much less stressful way for them to explain their symptoms to their GP.

Does online consulting work best in inner cities?

Wherever people live, and no matter how distributed the population in your practice, online consulting offers patients an alternative way to consult with their GP. It works very well in rural areas as well as conurbations, because an eConsult can save the patient a trip to the surgery – a particular bonus for those in remote areas, where public transport is less readily available.

We’ve had online access on offer to patients for several years but uptake is very low. Why should eConsult be any different?

A lot of practices have a website, and many offer patients online appointment booking. But often uptake is low because the website either isn’t promoted very well or, once patients visit the website, the services are not easy to access. With eConsult, patients are driven towards online consulting first – rather than telephone or face-to-face appointments. This has two key benefits. First, patients are often able to self-help or make routine admin transactions without the need to see their GP, thus reducing the number of consultations needed. Second, if your patient population becomes confident in transacting with eConsult, it is more likely that they will interact with other areas of the practice’s website too.

Will online consulting save me money?

eConsult provides GP practices with an efficiency: saving GPs time. Practices have several options for maximising this efficiency. They could choose to save money by keeping their queue at its current length and hiring fewer locums, for example, or not replacing a GP when somebody leaves the practice. Or they could opt to improve their patients’ experience by shortening their queue and keeping the same number of staff. They could also direct the efficiency towards those who need more time with their GP – spending the time saved through eConsults on face-to-face consultations with patients who have complex or chronic conditions.

eConsult empowers GPs, putting them in control. Most practices will choose a combination of efficiencies for better patient outcomes and a more effective use of practice resources.