Observational studyBMJ open2017
Use of a primary care online consultation system, by whom, when and why: evaluation of a pilot observational study in 36 general practices in South West England.
Observational study in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 63 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
63 citing papers in PubMed, 5 syntheses or guidelines pooled it, 120 citations in OpenAlex.
- Patient-facing online triage tools and clinician decision-making: a systematic review.BMJ open · 2025Pooled it
- A theory-based analysis of the implementation of online asynchronous telemedicine platforms into primary care practices using Normalisation Process Theory.BMC primary care · 2025Pooled it
- The impact of eHealth use on general practice workload in the pre-COVID-19 era: a systematic review.BMC health services research · 2024Pooled it
- Understanding How the Design and Implementation of Online Consultations Affect Primary Care Quality: Systematic Review of Evidence With Recommendations for Designers, Providers, and Researchers.Journal of medical Internet research · 2022Pooled it
- Artificial Intelligence Techniques That May Be Applied to Primary Care Data to Facilitate Earlier Diagnosis of Cancer: Systematic Review.Journal of medical Internet research · 2021Pooled it
- Videoconferences between remote-sitting specialist, patient and practice staff concerning low prevalent diseases and complex pathways in general practice clinics: a feasibility study.Scandinavian journal of primary health care · 2026Review
- Article
- Digital Information Sharing Before Consultations in General Practice: Protocol for a Scoping Review.JMIR research protocols · 2025Article
- Digitalization of Access to Primary Care: Is There an Equity-Efficiency Trade-Off?Health economics · 2025Article
- Acceptability of Guided Symptom Entry and Asynchronous Clinical Communication Software Among Primary Care Staff: Qualitative Study.JMIR formative research · 2025Article
- Uses of Virtual Care in Primary Care: Scoping Review.Journal of medical Internet research · 2025Article
- Patterns of online consultation use in Great Britain, 2019-2023: an observational analysis.BMJ digital health & AI · 2025Article
- Access systems in general practice: a systematic scoping review.The British journal of general practice : the journal of the Royal College of General Practitioners · 2024Article
- The Use of Online Consultation Systems or Remote Consulting in England Characterized Through the Primary Care Health Records of 53 Million People in the OpenSAFELY Platform: Retrospective Cohort Study.JMIR public health and surveillance · 2024Article
- Article
- Effectiveness and safety of asynchronous telemedicine consultations in general practice: a systematic review.BJGP open · 2024Article
- Ethical considerations in prevention and management of non-communicable diseases: a narrative review.Journal of medical ethics and history of medicine · 2024Review
- Patients' suggestions for improvements to text-based e-consultations. An online survey of users of the national health portal in Norway.Frontiers in digital health · 2024Article
- Impact of virtual visits on primary care physician work flows.Canadian family physician Medecin de famille canadien · 2023Article
- Workload effects of online consultation implementation from a Job-Characteristics Model perspective: a qualitative study.BJGP open · 2023Article
3 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesEvaluation of a pilot study of an online consultation system in primary care. We describe who used the system, when and why, and the National Health Service costs associated with its use.
design15-month observational study.
settingPrimary care practices in South West England.
results36 General practices covering 396 828 patients took part in the pilot. The online consultation website was viewed 35 981 times over the pilot period (mean 9.11 visits per 1000 patients per month). 7472 patients went on to complete an 'e-consultation' (mean 2.00 online consultations per 1000 patients per month). E-consultations were mainly performed on weekdays and during normal working hours. Patient records (n=485) were abstracted for eight practices and showed that women were more likely to use e-consultations than men (64.7% vs 35.3%) and users had a median age of 39 years (IQR 30-50). The most common reason for an e-consultation was an administrative request (eg, test results, letters and repeat prescriptions (22.5%)) followed by infections/immunological issues (14.4%). The majority of patients (65.2%) received a response within 2 days. The most common outcome was a face-to-face (38%) or telephone consultation (32%). The former were more often needed for patients consulting about new conditions (OR 1.56, 95% CI 1.05 to 2.27, p=0.049). The average cost of a practice's response to an e-consultation was £36.28, primarily triage time and resulting face-to-face/telephone consultations needed.
conclusionsUse of e-consultations is very low, particularly at weekends. Unless this can be improved, any impact on staff workload and patient waiting times is likely to be negligible. It is possible that use of e-consultations increases primary care workload and costs. Online consultation systems could be developed to improve efficiency both for staff and patients. These findings have implications for software developers as well as primary care services and policy-makers who are considering investing in online consultation systems.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.