Abstract
Background: Health service policy in many jurisdictions is driving greater investment into digital primary care services. While some patients and practices may benefit, there are concerns that not all are able or wish to access primary care services online. “Digital facilitation” is the “range of processes, procedures, and personnel seeking to support patients in their uptake and use of online services” and may address such concerns. Objective: As part of a multimethod research program, we undertook surveys of practice staff and patients to gain insight into the support being offered by practices and explore patients’ experiences of this support. Methods: General practices from 4 regions of England were sent a questionnaire exploring the modes of digital facilitation offered, the personnel involved in its delivery, and views on the motivations and drivers for providing support. Moreover, 12,822 patients registered with 62 general practices (predominantly those providing practice survey responses) were sent a questionnaire exploring their experiences of any support offered by their practice to use online services. Results: Almost one-third of practices (156/500, 31.2%) responded to the practice survey, with most reporting using passive modes of digital facilitation (eg, display, leaflets, and SMS text messages) and few using active modes (eg, offering tablets or computers or using practice champions). However, 90.9% (130/143) reported providing ad hoc support. Practices agreed that it was the responsibility of both the practice (105/144, 72.9%) and the wider National Health Service (118/143, 82.5%) to support patients in using online services and that providing such support benefited the practice (126/144, 87.5%) and their patients (132/144, 91.7%). Nearly a quarter of the patients (3051/12,822, 23.8%) responded to the patient survey, with few (522/3051, 17.11% or less) reporting awareness of any modes of digital facilitation apart from text messages and emails (1205/3051, 39.5%) and only 13.36% (392/2935) reporting receiving support to use online services. Adjusted logistic regression analyses showed that older patients had a lower likelihood of 4 outcomes: being aware of, or of using, digital facilitation efforts, or being told about or being helped to use online services (all P<.05), particularly with regard to being helped to use online services (adjusted odds ratio for patients aged 85 years versus those aged 55-64 years: 0.08, 95% CI 0.02-0.36). However, ethnic minority participants or those for whom their first language was not English had positive associations with these outcomes. Conclusions: General practices recognize that patients would benefit from support to access online services. However, the support provided is often passive or ad hoc, and patients were seldom aware of digital facilitation efforts that their practice provided. There is potential to increase engagement with online primary care services by providing more support for all patients, particularly to provide targeted support for older patients.
Original language | English |
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Article number | e56528 |
Journal | Journal of Medical Internet Research |
Volume | 26 |
Early online date | 7 Aug 2024 |
DOIs | |
Publication status | Published - 7 Aug 2024 |
Acknowledgements
The authors would like to acknowledge and thank the following people for their contributions to the research project from which this paper was developed: research team colleagues Wiktoria Bak, Hamish Evans, Evangelos Gkousis, Georgia Jenkins, Caroline Jenkinson, Nada Khan, Brandi Leach, Jennifer Newbould, Sarah Parkinson, Joanne Parsons, Emma Pitchforth, Laura Sheard, Stephanie Stockwell, and Bethan Treadgold; patient advisory group members Laiya Bailey, Julie Harvey, Diana Lewis-Frost, Ben Marshall, Andrea Shelly, Lynn Tatnell, Penny Thompson, and Malcolm Turner; steering group committee members Jeremy Horwood, David Parkes, and Amrit Takhar; sponsors Pam Baxter and Vivienne Shaw; sponsor team members Sarah Hider and Alexander Philips; administrator Ellie Kingsland; survey support staff members Jodie Button, Mayam Gomez-Cano, Sine MacDonald, Isabelle Mayne, Charlotte Reburn, and Claire Wright; initial study advice from Richard Moore; clinical research networks East of England, North Thames, North West Coast, South West Peninsula, and West Midlands; and all patients and practice staff who supported and participated in the study.Funding
This study was funded by the National Institute for Health and Care Research Health and Social Care Delivery Research Programme (128268).
Funders | Funder number |
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School for Social Care Research | 128268 |
Keywords
- access to online health care services
- digital support
- digital technology
- general practice
- health services research
- inequalities
- online services
- primary care
- remote consultation
- survey
ASJC Scopus subject areas
- Health Informatics