When your doctor is online: People expect a reply within 24 hours

Why did you send a written e-consultation to your GP? What did you expect? What would you have done if the service did not exist?

In a nationwide survey on the Norwegian health portal Helsenorge, 13,011 users answered a range of questions about e-consultations.

An e-consultation – sometimes also referred to as a virtual doctor visit – is a doctor's appointment that takes place digitally via text, audio, or video.

What do people use e-consultations for?

The most common reason was to request sick leave or other forms of medical certification. 

Many also used e-consultations for questions about a known problem. About one in four cases concerned a new health problem.

E-consultations are often patients' first choice, according to researcher Eli Kristiansen at the Norwegian Centre for E-health Research.

She is one of the researchers behind the new study showing that clear guidance is needed to ensure safe and appropriate use.

The study shows that the service is used instead of visiting the GP in around half of cases.

In many cases, the service is also used as an additional service alongside GP appointments.

Expect a quick reply

The study shows that almost seven out of ten patients expect a reply within 24 hours. The national standard says doctors should respond within five working days.

Patients' expectations of fast replies may lead to the service being used for acute issues, even though this is not recommended.

“The study shows that e-consultations are often built around a template that does not reflect the full range of patients' needs. Patients want a more personalised service,“ says Kristiansen.

The right channel at the right time

Without e-consultations, nearly half of the patients would have booked a regular appointment with their doctor. About as many would have called the reception. Few stated out-of-hours services as an alternative. 

A smaller share would not have contacted healthcare services at all if e-consultations were not available. Instead, they would have waited or looked for information online.

The study shows that patients found it difficult to assess which issues are suitable fornn written consultations. 

Many said they would contact the doctor through a written e-consultation even if they believed a physical examination by a doctor was necessary.

Kristiansen points out that correct use is important both for patient safety and for managing GPs' workload. Clear advice to patients about when e-consultations are appropriate, and when they are not, can help.

What does this mean for the GP practice?

E-consultations can reduce pressure, as some cases are resolved in writing instead of in person. At the same time, high expectations for response times may mean that more urgent cases end up in the wrong channel.

The message of the study is therefore clear:

"Use e-consultations for simple, non-urgent questions, and contact the doctor for immediate or worrying symptoms," says Kristiansen.

Personalised service

Patients want a more personalised service in line with the GP scheme as they know it.

An earlier study by Kristiansen points in particular to fixed forms as a barrier. 

"It can be tiring for patients to describe their health problems using standardised questions, especially when they know their GP is already familiar with the issues," she says.

At the same time, it's important to remember that the e-consultation service must be sustainable. There are GPs on the other side who must handle the flow of messages. Further research should focus on understanding GPs' perspectives and needs regarding the e-consultation service.

"In addition, we should explore whether generative artificial intelligence can help patients describe their issues better," Kristiansen says.

References:

Kristiansen et al. Patients' Use of e-Consultations as an Alternative to Other General Practitioner Services: Cross-Sectional Survey Study, Journal of Medical Internet Research, vol. 27, 2025, DOI: 10.2196/55158

Kristiansen et al. Patients' suggestions for improvements to text-based e-consultations. An online survey of users of the national health portal in Norway, Frontiers in Digital Health, 2024. DOI: 10.3389/fdgth.2024.1459684

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