The challenge of e-communication in primary healthcare

A major problem in primary healthcare is the communication between patient, family and the multitude of caregivers. Face-to-face multi-disciplinary consultation is no longer feasible in practice. Digital communication can be a tool to solve this problem. Two digital communication tools are evaluated, with feasibility as primary focus point (whether it is used by patients, family, caregivers). The tools are characterized by a combination of a patient file and a secure communication channel. The tool Congredi is an electronic care-plan in which professionals/patients can view the plan and communicate by e-mail and professionals can adjust it. The tool eMAR-PCT allows pharmacists/patients to share e-medication records and communicate by e-mail about errors/questions. Firstly it was found that, in line with the innovation-implementation theory of Rogers, a limited part (about 25%) of the users actually used the tools. Innovative technology is used initially by the most motivated and the majority follows. Secondly, the respondents did not indicate impeding factors with regard to the technology. Thirdly, we found that a large proportion of the professionals involved did not connect and/or did not respond to actions in the tool. This limited (active) involvement of professionals was perceived as a barrier because everyone needs to be connected for a response to each other's reaction. Fourthly, in the eMAR study an increase on self-management was shown (self-efficacy/communication with pharmacist). Conclusion: e-communication tools combining shared data and secure communication seem promising to address the challenges in primary healthcare. Focus on feedback and netiquette is advisable for successful implementation