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Conference Abstracts

Patient and healthcare professional perspectives on a digital first general practice: an evaluation study


Romy Willemsen

Leiden University Medical Center, Netherlands, ES
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1: Leiden University Medical Center, Netherlands

Introduction: The pressure on general practitioners (GPs) is rising due to an ageing population and an increasing prevalence of chronic diseases. The use of eHealth is suggested to increase the accessibility of healthcare, with the additional potential of lowering costs. ‘Flexdoctors’ is a concept for general practices that incorporates eHealth in the organizational aspects of the practice. Flexdoctors uses digital communication and remote healthcare delivery. Via a web application, patients can schedule their appointments, send e-consults, chat with a GP, reorder medication for chronic conditions and view their patient files.  First contact (i.e., triage) and telephone consults are with the GP. 

Objective & Methods: This study aimed to provide insight into patient and healthcare professional experiences. The primary study outcomes were acceptability, the implementation process, suggestions for improvement, and facilitators and barriers for future implementation.

A mixed-methods design was used. Online questionnaires and focus groups were used to identify patient perspectives, and in-depth interviews with healthcare professionals identified their perspectives. Participants were from three general practices that implemented this concept over a half year ago. Overall acceptability in patients was assessed on a 5-point Likert scale and satisfaction with the Client Satisfaction Questionnaire-8. All primary outcomes were qualitatively assessed in patients and healthcare professionals.

Key findings: A total of 626 participants completed the online questionnaires. Five focus groups with patients and ten in depth-interviews with healthcare professionals were held. Patient acceptability of the Flexdoctors concept and care was high (M = 3.89, SD = 1.01; N.B. scale from 1-5), and patients were satisfied with their care (M = 28, SD = 0.51; NB. scale from 8-32). Regarding the perceived quality of consults, patients were positive about the longer duration of physical consults (i.e., 20 instead of 10 minutes). They mainly had online contact with their GP for minor problems. Overall, patients were satisfied with the doctor-patient relationship due to increased direct contact with their GP. However, some indicated they had a less personal relationship because various GPs were involved in their care. GPs considered the quality of consults either similar or improved, and the latter group often indicated this was due to the longer duration of on-site appointments.

Conclusions: Overall, patients and healthcare professionals were positive about Flexdoctors. This study gives insight in how to improve the implementation process of Flexdoctors and the concept itself.

Implications: The Flexdoctors concept can help to improve the accessibility of healthcare for both patients and healthcare professionals. Currently, ten practices in the Netherlands are working with this concept, with more practices to come. The Flexdoctors concept provides the GPs tools to run their practice, whilst the actual implementation can vary per practice.


How to Cite: Willemsen R. Patient and healthcare professional perspectives on a digital first general practice: an evaluation study. International Journal of Integrated Care. 2022;22(S3):283. DOI:
Published on 04 Nov 2022.


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