E-consulting in a medical specialist setting: Medicine of the future?. Issue 5 (May 2016)

• Record Type: Journal Article
• Authors: Zandbelt, Linda C.; de Kanter, Froukje E.C.; Ubbink, Dirk T.
• Is Part Of: Patient education and counseling. Volume 99:Issue 5(2016)
• Page Start: 689
• Page End: 705
• Publication Date: 2016-05
• Subjects: E-consult -- Videoconferencing -- Web-messaging -- Physician–patient relationship -- Communication -- Satisfaction -- Time -- Costs; Patient education -- Periodicals; Health counseling -- Periodicals; Health education -- Periodicals; Counseling -- Periodicals; Patient Education -- Periodicals; Éducation des patients -- Périodiques; Counseling -- Périodiques; Éducation sanitaire -- Périodiques; 615.5071
• DOI: 10.1016/j.pec.2015.11.005
• Languages: English
• ISSNs: 0738-3991

Abstract

Highlights: This systematic review assesses the effects of e-consulting by medical specialists. 21 trials were included, comparing e-consulting to conventional consultations. Physicians tend to prefer face-to-face consultations over videoconferencing. Videoconferencing is expensive for equipment but may save patient-related costs. E-consulting may be a feasible alternative to follow-up or telephone appointments. Abstract: Objective: Today's technology provides new ways of consulting between patients and medical specialists in health care, such as videoconferencing and web-messaging. In this systematic review we assessed the effects of e-consulting between medical specialists and patients. Methods: We searched MEDLINE, EMBASE, Psychlit and Cochrane Library for randomized clinical trials assessing the use of e-consulting methods (videoconferencing (VC) or web-messaging (WM)), as compared to conventional care (face-to-face (FF) or telephone consultations (TC)) in a medical specialist setting. We extracted patient-related, physician-related, cost, time and follow-up outcomes. Results: We included 21 trials, of which 17 addressed VC compared to FF, two compared WM with FF, one VC with TC, and one WM with TC. Physicians appeared to prefer face-to-face consultations over videoconferencing. Patients appeared to be as satisfied with videoconferencing as with face-to-face contacts, but preferred videoconferencing and web-messaging over telephone consultations. Videoconferencing was more expensive regarding equipment, but saved patient-related costs in terms of time, transportation, and missed work. Variable results were found for consult time and follow-up visits. Conclusions and practice implications: We cautiously conclude that e-consulting seems a feasible alternative to medical specialists' face-to-face follow-up or telephone appointments, but may be less suitable for initial consultations requiring physical examination.