Exploring the potential of email as a method of consultation in English general practice
Author(s)
Atherton, Helen Carina
Type
Thesis
Abstract
Background
Email is a popular and commonly used method of communication, though not widely used in
the healthcare setting. In England, policy has pushed for the introduction of email as a
method of consultation in general practice. However, there is very little evidence available on
its use in England and professional bodies have taken a neutral or negative stance to its
use. The aim of this study was to explore the potential for email as a method of consultation
in English general practice, and describe the key factors that may influence its normalisation.
Methods
A mixed methods approach was used. A systematic review was carried out to identify the
extent of the experimental evidence base. An interview study was carried out with patient
and professional (GPs, practice managers) participants who had used email for consultation,
to establish their experiences and opinions, and to identify barriers and facilitators to its use.
Normalisation process theory was used in interpreting the interview study results, so that the
factors influencing normalisation might be identified.
Results
The review found that the existing evidence base for email consultation is poor and as such
it is not possible to draw conclusions as to the effect of email as an intervention. The
interview study identified that email consultation largely arose as a result of patient demand,
and it brought advantages for both groups. However there were problems associated with it
and these related largely to the uncertainties surrounding its use.
Conclusions
Email consultation is not a normalised method of consultation in English general practice
despite the positive factors that patients and professionals associate with its use. It lacks a
regulatory framework, which makes it difficult to use. Formal guidance on how to approach
its use is required, along with methodologically rigorous research upon which policymakers
and practitioners can base their decision making.
Email is a popular and commonly used method of communication, though not widely used in
the healthcare setting. In England, policy has pushed for the introduction of email as a
method of consultation in general practice. However, there is very little evidence available on
its use in England and professional bodies have taken a neutral or negative stance to its
use. The aim of this study was to explore the potential for email as a method of consultation
in English general practice, and describe the key factors that may influence its normalisation.
Methods
A mixed methods approach was used. A systematic review was carried out to identify the
extent of the experimental evidence base. An interview study was carried out with patient
and professional (GPs, practice managers) participants who had used email for consultation,
to establish their experiences and opinions, and to identify barriers and facilitators to its use.
Normalisation process theory was used in interpreting the interview study results, so that the
factors influencing normalisation might be identified.
Results
The review found that the existing evidence base for email consultation is poor and as such
it is not possible to draw conclusions as to the effect of email as an intervention. The
interview study identified that email consultation largely arose as a result of patient demand,
and it brought advantages for both groups. However there were problems associated with it
and these related largely to the uncertainties surrounding its use.
Conclusions
Email consultation is not a normalised method of consultation in English general practice
despite the positive factors that patients and professionals associate with its use. It lacks a
regulatory framework, which makes it difficult to use. Formal guidance on how to approach
its use is required, along with methodologically rigorous research upon which policymakers
and practitioners can base their decision making.
Date Issued
2012-01
Date Awarded
2012-07
Copyright Statement
Attribution NoDerivatives 4.0 International Licence (CC BY-ND)
Advisor
Car, Josip
Pappas, Ioannis
Murray, Elizabeth
Sponsor
Medical Research Council (Great Britain)
Publisher Department
Medicine
Publisher Institution
Imperial College London
Qualification Level
Doctoral
Qualification Name
Doctor of Philosophy (PhD)