title: eDiagnostics: a promising step towards primary mental health care.
abstract: BACKGROUND
  There is a growing interest in eHealth applications in daily health care. Considering that a psychological examination, to a large extent, consists of filling out questionnaires, the use of the Internet seems logical. We evaluated an eDiagnostic system for mental health disorders that has recently been introduced in primary care in the Netherlands.
  
  
  METHODS
  We monitored the diagnoses produced by the system. Evaluation questionnaires from both GPs/practice nurses (PNs) and patients were collected. In addition, we compared the advice produced by the GPs/PNs and the advice produced by the system.
  
  
  RESULTS
  The most prevalent disorders were mood, anxiety and somatoform disorders (n = 353). Patients (n = 242; 74% response rate) were moderately enthusiastic about the eHealth approach, and GPs/PNs (n = 49, 72% response rate per practice) were very enthusiastic. Patients showed no clear preference for a face-to-face consultation with a psychologist over an eDiagnostic system. GPs/PNs felt strengthened in their control function. In most cases, the system gave a different echelon advice (i.e. referral to primary or secondary mental health care) than the GPs/PNs (κ = 0.13, P = 0.003). Nevertheless, GPs/PNs accept the results of the examination and the advice given.
  
  
  CONCLUSIONS
  Using the Internet to diagnose mental health problems in primary care seems very promising. This system of using eDiagnostics before referral to a mental health institution may change the management of mental health care. Further research should investigate whether this tool is valid, reliable and (cost) effective.
authors.affiliation: School for Public Health and Primary Care (CAPHRI), Department of General Practice, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
authors.forename: Ies
authors.initials: I
authors.lastname: Dijksman
authors.forename: Geert-Jan
authors.initials: GJ
authors.lastname: Dinant
authors.forename: Mark G
authors.initials: MG
authors.lastname: Spigt
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003936:Diagnosis, Computer-Assisted; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis*; D008603:Mental Health; D008875:Middle Aged; D009426:Netherlands; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000379:methods*; D011795:Surveys and Questionnaires; D017216:Telemedicine / Q000379:methods*; D055815:Young Adult
keywords: eDiagnostics; general practitioner; mental health disorders; practice nurse; prevention; primary care.