Perceptions, facilitators and barriers of digital interdisciplinary consultation: a qualitative study.

Abstract

The demand for care is increasing in volume and complexity. Digital interdisciplinary consultation (DIDC) has the potential to support general practitioners (GPs) with specialist knowledge and prevent unnecessary referrals. Successful DIDC requires collaboration between stakeholders with potentially different goals, barriers and motivations. Little is known about this broader context of DIDC. To identify stakeholders' perceptions about DIDC including barriers and facilitators to its use. Semistructured interviews with seven stakeholder groups in the Netherlands. We used purposive sampling to attain various stakeholders. The semistructured online or telephone interviews were transcribed verbatim and analyzed thematically. We interviewed 46 stakeholders (12 GPs, 10 medical specialists, 11 patients, 3 health insurance representatives, 6 platform developers, 3 primary-secondary care coordinators (PSCCs), and 1 chief medical information officer). We identified six themes: effectiveness, implementation requirements, evaluation of DIDC use, impact on networked care, acceptance by patients and future use of DIDC. Overall, stakeholders were positive about DIDC. The expected impact of DIDC on the accessibility and affordability of healthcare varied from modest to high. Agreements on collaboration and funding, and the need for user-friendly digital platforms were identified as the most important requirements for successful implementation. Physicians particularly appreciated the asynchronous nature of DIDC and the time saved. Patients appreciated receiving timely care, free from a deductible excess and avoiding unnecessary hospital visits. This study shows that all stakeholders were overall positive about DIDC. Agreements on organization, collaboration, financing, and platform design are essential.