Digital enabled primary care services: an overview of required functionalities, managerial implications and ethical considerations

Nick Guldemond

Keywords: Digital, Platforms, Primary Care, Family Medicine, Integrated care, Person Centred Care


Digital technology plays a pivotal role in the daily work of family doctors with patients and colleagues. Digital solutions can make healthcare services more timely, collaborative, efficient and tailored to the needs of people. However, no comprehensive view on required functionalities, managerial implications and ethical considerations for digital health services from the perspective of family doctors exist today. Therefore, the World Organisation of Family Doctors (WONCA) explored a framework for digital enabled primary care services.


Bases on literature review and interviews, relevant topics for a digital enabled primary care services framework was defined. In total, 112 items were clustered in 11 domains for the appreciation of digital services from both an operational and health system perspective. Various digital platforms were assessed through this conceptual framework.


Most digital platforms consist of an artificial intelligent support functionalities e.g. anamnesis, clinical reasoning based diagnosis, suggestion for treatment options. Often a network of on/ and-or offline doctors and specialists were connected to the platform as well as a network of associated suppliers like pharmacies. From a patient perspective, these digital platforms usually provide a variety of easy accessible digital health services but many aspects such as quality, affordability, continuity and comprehensiveness of care, especially for patients with chronic conditions and comorbidities, are not secured and transparent. In addition, little to none scientific evidence for cost-effectiveness, benefits and risks as well as the validity and reliability of these service platforms are available.


Although, the implementation and scalability of the digital platforms are technically relatively simple, the interoperability with other information systems is difficult. Also the transferability of successful concepts to other settings is complex due to technological, legal and cultural requirements. The evaluation showed that digital platforms have a great potential to make primary care better accessible, efficient and support the work of family doctors.