title: [Email in a dedicated headache clinic: experience gained over a five-year period].
abstract: BACKGROUND
  The use of email can facilitate communication between the different levels of an organisation. Our primary care physicians have had an email service in the dedicated headache clinic (DHC) since November 2009, and our aim is therefore to analyse the use of email over that five-year period.
  
  
  METHODS
  Data concerning the emails sent up until October 2014 were collected prospectively. The questions were classified as need for referral to the DHC (group 1), progress made by the cases seen in the DHC (group 2), training in headaches (group 3) or the treatment of the headaches suffered by primary care physicians themselves as patients (group 4).
  
  
  RESULTS
  A total of 274 email messages were analysed. Monthly consultations have increased (from 1.5 per month during the first year to 7.5 per month during the fifth). Findings showed that 10.2% of the email messages came from rural health centres and 89.8% were sent from urban health centres. Replies were sent within 2 ± 2.8 days (range: 0-24 days). Altogether 130 consultations were classified as belonging to group 1 (47.4%), in which referral through the normal channel was recommended in 60 cases (46.2%), via the preferential channel in 47 (36.2%) and non-referral was suggested in 23 cases (17.6%). Group 2 included 125 emails (45.7%) and in 80 cases there was no need to make a new appointment or to bring forward the existing one (64%). Thirteen visits (4.7%) were classified into group 3 and six (2.2%) in group 4.
  
  
  CONCLUSIONS
  Our primary care physicians are using the email of the DHC on an increasingly more frequent basis. Its use makes it possible to detect patients whose appointment -whether the first or a follow-up- needs to be brought forward, as well as allowing issues to be solved without the need for referral. It is effective for the treatment of physicians who themselves have headaches and as a tool for continuing education.
authors.forename: M Isabel
authors.initials: MI
authors.lastname: Pedraza
authors.forename: Sonia
authors.initials: S
authors.lastname: Herrero-Velázquez
authors.forename: Luis
authors.initials: L
authors.lastname: López-Mesonero
authors.forename: Marina
authors.initials: M
authors.lastname: Ruiz-Piñero
authors.forename: Javier
authors.initials: J
authors.lastname: Posadas
authors.affiliation: Hospital Clinico Universitario, 47005 Valladolid, Espana.
authors.forename: Ángel L
authors.initials: ÁL
authors.lastname: Guerrero-Peral
mesh_terms: D034742:Electronic Mail / Q000706:statistics & numerical data*; D006261:Headache / Q000628:therapy; D006782:Hospitals, Special; D006801:Humans; D011446:Prospective Studies; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D013997:Time Factors