CONTACT: Content analysis of email consultations between general practitioners and patients.

Problem

Early adopter GPs are experimenting with the use of email for consulting with patients and trying to establish good practice. Although we know this is happening, and we know how GPs and patients feel about it, we do not know anything about what GPs and patients communicate about using this medium. Previous content analyses of GP-patient emails in primary care in the US found no evidence to support clinicians’ worries about how patients used email consultation, revealing that patients adhered to guidelines about how to utilise email consultation and clinician fears about being overwhelmed with emails were not realised. However, there are numerous differences between the US and UK health systems. We will conduct the first UK-based content analysis of email consultations in two general practices. Information on this use is valuable in determining how email consultation might work more widely across general practice.

Approach

We will analyse email exchanges from two practices in the UK; one in Oxford and in an area of low deprivation, and one in Greater Manchester in an area of high deprivation. In both practices there are individual GPs using email to consult with patients and this is outside of any formalised consultation system. Each practice will make their last 50 email exchanges available to us, anonymising the emails. We will also collect (separately from email content) the age and gender of the patients with each email, and age, gender and year of qualification for GPs. We will apply a content analysis to explore and delineate content of consultations conducted via email including type of clinical content, number of emails in exchange and timing of emails.

Findings

This study is in set up and by July 2016 we will have present our findings. The data will be coded according to the following categories, along with any other codes arising out of the data. • Administrative and/ or clinical content. • Categories of type of clinical content (guided by previous content analyses carried out in the US where content was categorised clinically.) • Safety concerns expressed by either correspondent and/or identifiable. • Use of attachments e.g. images, audio files or other supplements• Number of emails in each exchange. • Time of day emails were sent and responded to, both by patients and GPs.

Consequences

Information on the use of email consultation is valuable in determining how email consultation might work more widely across general practice. We will apply our analysis to develop a typology of email consultations and identify any safety issues associated with this method of consultation. This will have utility for researchers who wish to find out more about the impact of email consultation in general practice, and for general practices that are considering the adoption of email consultation in general practice.