Electronic consultations between general practitioners and hospital specialists: Shifting expertise, not patients

This dissertation examined the use, experiences, and effects of the e-consultation: digital communication in which general practitioners request advice from medical specialists. The e-consultation proved widely applicable and particularly suitable for medical specialties, especially internal medicine. It improves access to specialist expertise, enhances communication, and has educational value. Patients appreciate that their GP can seek advice without a direct referral, although the desired level of involvement varies by situation.

Across all specialties, most e-consultations led to avoided referrals, while only a small number resulted in additional referrals. Due to the limited volumes, there was no measurable effect on the total number of referrals; only internal medicine showed a regional decrease that was not significant compared with national trends.

Selecting appropriate outcome measures and conducting follow-up research on contextual factors are important to better understand the effects. Regional collaboration, education, and joint training are essential for proper use. Future research could further enhance knowledge sharing, for example through artificial intelligence.