Collaboration between general practitioners and psychiatrists via digital platforms in the Netherlands: advantages and specific limiting factors

Dutch secondary psychiatric care tends to have long referral times. Accessible consultation between general practitioners (GPs) and specialists can reduce unnecessary referrals and treatment delays. This study aims to gauge the opinions of GPs on consultation regarding psychiatric cases through the e-consultation-platform Prisma. Dutch GPs with access to the physician-to-physician e-consultation platform called Prisma were invited through purposive sampling. Both active and passive users were included, some of whom had requested specialist consultation on psychiatric queries. Audio recordings of the semi-structured interviews with the GPs were transcribed and coded axially by two researchers working independently, before re-analyzing both coded texts and combining them into one definitive codebook. Between December 14th, 2020, and March 16th, 2021, interviews were held until data saturation was reached. GPs tended not to consider the Prisma platform as suited for most psychiatric queries, citing the general complexity and nuance of psychiatric cases and the decentralized nature of the platform as reasons, among others. They did recognise added value in using Prisma for concrete mental health-related questions, mostly regarding medication or specific referrals. GPs are overall positive about interdisciplinary e-consultation with specialists using Prisma. However, they tend to use it more for somatic cases rather than psychiatric cases. The specific psychiatric cases that GPs liked to use the e-consultation tool for were specific questions about pharmaceutical management and special referrals.