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Digital interdisciplinary consultation in Dutch primary care

Digital intercollegiate consultation (DICO) allows healthcare professionals to consult each other more easily, which may lead to better and faster patient care. Despite this promise, current scientific evidence is still limited and largely based on observational research; large-scale, robust RCTs are mostly lacking. 

Aim

The aim of this project was to provide more insight into the use and efficiency of digital intercollegiate consultation (DICO). 

Conclusions

  • Digital intercollegiate consultation (DICO) shows potential to increase efficiency in healthcare and to provide patients with the right care at the right place and time more frequently. Despite this promise, current scientific evidence is still limited and largely based on observational research; large-scale, robust RCTs are mostly lacking. Practical experience does show high satisfaction among users—patients, general practitioners, and specialists.
  • However, implementing DICO requires attention to aspects such as workload, clear allocation of responsibilities, and practical preconditions like ease of use and platform flexibility. For general practitioners, integration of DICO within the medical record is essential, as are rapid feedback and simple documentation.
  • The potential applications are wide-ranging, with opportunities in fields such as geriatric medicine, mental health care, and education. Support for digital communication, both between physicians and towards patients, is significant. It is important, however, to allow room for pragmatic further development.
  • Patient involvement when using DICO is often limited and context- and preference-dependent, with the general practitioner playing a central role. Providing patients with good information about the use of DICO and their role in it is necessary and should be adapted to the type of question and specific situation. This can contribute to a more patient-centered implementation.
  • It has been shown that general practitioners use multidisciplinary DICO more often for diagnostic questions, whereas one-on-one consultations are mainly used for referral questions. The exact distribution varies per medical specialty.

Recommendations

  • Future research, in addition to outcome measures such as the number of referrals, should primarily focus on the impact on quality, safety, and optimal integration of DICO into daily healthcare practice.
  • Patient involvement in DICO is low and should be improved. Different types of platforms are used by GPs for different types of cases. This helps users make a choice as to which type of platform is most suitable for which type of case.
  • Implementing DICO requires attention to aspects such as workload, clear allocation of responsibilities, and practical preconditions like ease of use and platform flexibility. For general practitioners, integration of DICO within the medical record is essential, as are rapid feedback and simple documentation.

Addressing knowledge questions

These insights partially address the broadly formulated research questions from the National Research Agenda for General Practice. We have mapped what stakeholders consider important when evaluating eHealth innovations for digital consultation, what barriers general practitioners perceive in the use of these innovations, what kind of information exchange takes place, and how patients are involved.

Continuation

A new grant has been obtained for a follow-up of the results of this project: 

Products

Title: Module Transmurale Digitale Consultatie
Title: Nieuw onderzoek naar typen digitale consultatieplatformen
Author: Petra Buist
Magazine: Huisarts & Wetenschap
Title: Exploring patient involvement and influencing factors in digital interdisciplinary consultation
Author: Ken MM Peeters, Carmen Y. Hidding, Petra Buist, Sanne M. Sanavro, Dennis van der Lugt, Joke Stoffelen, Marco H. Blanker, Henk van der Worp, Henk J. Schers, Esther Giroldi, Jochen WL Cals, Jesse Jansen
Magazine: Patient Education and Counseling
Link: https://www.sciencedirect.com/science/article/pii/S073839912500727X?via%3Dihub
Title: Perceptions, facilitators and barriers of digital interdisciplinary consultation: a qualitative study
Author: C Y Hidding, P Buist, K Peeters, J Cals, J Jansen, N D Scherpbier-de Haan, J Stoffelen, M H Blanker, H van der Worp, S M Sanavro, S M Grol, H J Schers
Magazine: Family Practice
Link: https://academic.oup.com/fampra/article/42/5/cmaf074/8267988?login=true#google_vignette
Title: Beschrijving van de data van de verschillende werkpakketten die binnen dit project zijn uitgevoerd.
Link: https://umcgresearchdatacatalogue.nl/all/collections/DICO
Title: Informatie filmpje voor patienten met een uitleg over digitaal consulteren.
Link: https://www.zorgbelanginclusief.nl/projecten/digitale-huisartsenzorg-huisartsen-raadplegen-specialisten-digitaal/
Link: https://www.zorgbelanginclusief.nl/projecten/digitale-huisartsenzorg-huisartsen-raadplegen-specialisten-digitaal/

Quick links

  • General practitioner care
  • Primary care
  • Interdisciplinary cooperation
  • Specialist medical care
  • Regional collaboration
  • Deciding together
  • Care innovations and quality

    • Features

    • Project number:
      10060022010001
    • Duration: 100%
      2022
      2025
    • Part of programme:
    • Related funding round:
      Complexe Vragen ronde 2020 UA-fase
    • Project lead and secretary:
      dr. H. van der Worp
    • Responsible organisation:
      Universitair Medisch Centrum Groningen

    Addressing prioritized knowledge questions

    To support daily general practice in providing appropriate care and assistance to patients, we invest in research addressing prioritized questions from the National Research Agenda for General Practice. Learn more about the projects.

    More project

    Other ZonMw-projects in which projectleader Henk van der Worp is of has been involved: