A patient perspective on eHealth in primary care: Critical reflections on the implementation and use of online care services

Smart devices like mobile phones with internet are becoming an indispensable part of our everyday lives. Digital solutions are expected to contribute to the healthcare sector (e-health) in the form of online patient portals and home measuring devices. Nevertheless, e-health is being utilised very little in daily practice. This dissertation focuses primarily on the patient's perspective, with the main aim of researching the need and the use of e-health by general practitioners. This dissertation also examines the implementation of e-health in the Netherlands in a broader context. It appears that e-health is not commonly used by patients due to a lack of: 1) understanding and information about the possibilities and advantages of e-health; 2) understanding about the possibilities and skills required to use e-health; and 3) the expected value of e-health in terms of disease-specific characteristics. The low usage rate of e-health may be particularly problematic for patients that could benefit from it, but do not have access to it or the ability or skills to use it. This dissertation found that e-health is not equally relevant for all patients and therefore does not have to be implemented for everyone. Its introduction in GP care depends on the efforts of the parties involved, including patients, healthcare providers, e-health developers, health insurers, the government and researchers. They will have to draw on their own perspectives and values and work together to point the large-scale deployment of e-health in the right direction.