Family practice · 2026
Evaluation of an interdisciplinary electronic consultation service between general practitioners and medical specialists in The Netherlands: a prospective cohort study.
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Peeters Ken M M, Muris Dennis M J, Klein Hesselink Juliette, Laeven Kirsten R A, Schotman Tessa, de Vries Guus G, Hendrickx Roel, Khajeh Ladbon, Stoot Jan, Bergmans Paul, Krekels Mariëlle, Cals Jochen W L
Аннотация
BACKGROUND: General practitioners (GPs) frequently encounter complex cases that require specialist input. Traditionally, this support is sought via telephone consultations, which are often constrained by time and availability, or through initiating a hospital referral. Interdisciplinary electronic consultations enable timely specialist advice while possibly reducing unnecessary referrals. Though prior research has shown promising outcomes for e-consultations, evidence remains limited, particularly from healthcare systems where GPs act as gatekeepers, such as in The Netherlands. It is also unclear whether similar benefits apply across other hospital departments.
OBJECTIVE: This study aimed to evaluate how GPs in a Dutch healthcare setting used e-consultations across multiple hospital departments, focusing on both the content of the consultations and their impact on referral decisions.
METHODS: We analyzed 2183 e-consultations submitted to Zuyderland Medical Centre between 2019 and 2022, with at least 24 months of data collected per department. Consultations were categorized by topic, and referral outcomes were assessed-specifically avoided versus additional referrals prompted by the e-consult.
RESULTS: E-consultations were used across all departments and addressed a wide range of clinical questions, most commonly related to diagnosis, diagnostic testing, and pharmacological treatment. In surgical departments, questions more often concerned general advice. Overall, 36.8% were avoided, while 11.9% additional referrals followed the e-consult. Avoided referral rates ranged from 32.6% in Pediatrics to 49.0% in Urology.
CONCLUSION: E-consultations support GPs in managing clinical uncertainty and may reduce unnecessary referrals, particularly when tailored to departmental contexts.
OBJECTIVE: This study aimed to evaluate how GPs in a Dutch healthcare setting used e-consultations across multiple hospital departments, focusing on both the content of the consultations and their impact on referral decisions.
METHODS: We analyzed 2183 e-consultations submitted to Zuyderland Medical Centre between 2019 and 2022, with at least 24 months of data collected per department. Consultations were categorized by topic, and referral outcomes were assessed-specifically avoided versus additional referrals prompted by the e-consult.
RESULTS: E-consultations were used across all departments and addressed a wide range of clinical questions, most commonly related to diagnosis, diagnostic testing, and pharmacological treatment. In surgical departments, questions more often concerned general advice. Overall, 36.8% were avoided, while 11.9% additional referrals followed the e-consult. Avoided referral rates ranged from 32.6% in Pediatrics to 49.0% in Urology.
CONCLUSION: E-consultations support GPs in managing clinical uncertainty and may reduce unnecessary referrals, particularly when tailored to departmental contexts.