title: Use and Uptake of eHealth in General Practice: A Cross-Sectional Survey and Focus Group Study Among Health Care Users and General Practitioners.
abstract: BACKGROUND
  Policy makers promote the use of eHealth to widen access to health care services and to improve the quality and safety of care. Nevertheless, the enthusiasm among policy makers for eHealth does not match its uptake and use. eHealth is defined in this study as "health services delivered or enhanced through the Internet and related information and communication technologies."
  
  
  OBJECTIVE
  The objective of this study was to investigate (1) the current use of eHealth in the Netherlands by general practitioners (GPs) and health care users, (2) the future plans of GPs to provide eHealth and the willingness of health care users to use eHealth services, and (3) the perceived positive effects and barriers from the perspective of GPs and health care users.
  
  
  METHODS
  A cross-sectional survey of a sample of Dutch GPs and members of the Dutch Health Care Consumer Panel was conducted in April 2014. A pre-structured questionnaire was completed by 171 GPs (12% response) and by 754 health care users (50% response). In addition, two focus groups were conducted in June 2014: one group with GPs (8 participants) and one with health care users (10 participants).
  
  
  RESULTS
  Three-quarters of Dutch GPs that responded to the questionnaire (67.3%, 115/171) offered patients the possibility of requesting a prescription via the Internet, and half of them offered patients the possibility of asking a question via the Internet (49.1%, 84/171). In general, they did intend to provide future eHealth services. Nonetheless, many of the GPs perceived barriers, especially concerning its innovation (eg, insufficient reliable, secure systems) and the sociopolitical context (eg, lack of financial compensation for the time spent on implementation). By contrast, health care users were generally not aware of existing eHealth services offered by their GPs. Nevertheless, half of them were willing to use eHealth services when offered by their GP. In general, health care users have positive attitudes regarding eHealth. One in five (20.6%, 148/718) health care users perceived barriers to the use of eHealth. These included concerns about the safety of health information obtained via the Internet (66.7%, 96/144) and privacy aspects (55.6%, 80/144).
  
  
  CONCLUSIONS
  GPs and health care users have generally positive attitudes towards eHealth, which is a prerequisite for the uptake of eHealth. But, general practitioners in particular perceive barriers to using eHealth and consider the implementation of eHealth to be complex. This study shows that there is room for improving awareness of eHealth services in primary care. It will take some time before these issues are resolved and eHealth can be fully adopted.
authors.affiliation: NIVEL, Utrecht, Netherlands. j.peeters@nivel.nl.
authors.forename: Jose M
authors.identifier: http://orcid.org/0000-0003-0317-1641
authors.initials: JM
authors.lastname: Peeters
authors.forename: Johan W
authors.identifier: http://orcid.org/0000-0002-6428-7333
authors.initials: JW
authors.lastname: Krijgsman
authors.forename: Anne E
authors.identifier: http://orcid.org/0000-0002-2601-7017
authors.initials: AE
authors.lastname: Brabers
authors.forename: Judith D De
authors.identifier: http://orcid.org/0000-0002-9549-9005
authors.initials: JD
authors.lastname: Jong
authors.forename: Roland D
authors.identifier: http://orcid.org/0000-0002-5602-826X
authors.initials: RD
authors.lastname: Friele
keywords: GPs, general practice; eHealth; health care users; implementation; survey; technology