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首页> 外文期刊>Journal of telemedicine and telecare >Electronic consultation impact from the primary care clinician perspective: Outcomes from a national sample
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Electronic consultation impact from the primary care clinician perspective: Outcomes from a national sample

机译:电子咨询来自初级保健临床医生视角的影响:国家样本的结果

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Introduction Electronic consultations (eConsults) provide asynchronous, store-and-forward communication between primary care clinicians (PCCs) and specialists using web-based platforms, electronic health records or mobile applications. eConsults have demonstrated benefits in many areas of the Quadruple Aim, including educational value for PCCs. In this study, we explored the connection between eConsults and the Quadruple Aim using a unique national dataset of PCC-reported eConsult outcomes. Methods We conducted a retrospective study analysing registry data from the RubiconMD electronic consultation platform used by PCCs in 34 US states. We analysed PCC-reported outcomes from eConsults that took place between March 2017 and January 2018. PCCs were asked to select one or more of the following options after each eConsult: improved care plan, educational, avoided unnecessary diagnostics/procedures, avoided referral altogether or to wrong specialty, or no effect. Results PCCs reported an outcome for 3872 eConsults. eConsults for dermatology, endocrinology, and haematology-oncology were most common. Over one in four PCCs reported that the eConsult avoided a referral altogether or to the wrong specialty (26.3%) and avoided unnecessary diagnostics/procedures (26.1%). In 75% of eConsults, PCCs reported an improved care plan. Fifty percent reported that the eConsult was educational. Discussion PCCs in diverse practice settings reported substantial benefits from eConsults. In over half of eConsults, PCCs reported that the eConsult avoided unnecessary diagnostics/procedures, avoided a referral altogether or avoided a referral to the wrong specialty. Findings suggest that eConsults demonstrate important educational benefits, but may also influence PCC decision-making in a way that yields tremendous cost-saving potential and improved patient experience.
机译:简介电子咨询(eConsults)在主要护理临床医生(PCCS)和专家之间使用基于Web的平台,电子健康记录或移动应用提供的专家之间提供异步,存储和前进通信。委员会在四重瞄准的许多领域都证明了益处,包括PCCS的教育价值。在这项研究中,我们探讨了委员会之间的联系,并使用PCC报告的Econsult结果的独特国家数据集。方法我们开展了一项回顾性研究,分析了34个美国州PCCS所使用的Rubiconmd电子咨询平台的注册表数据。我们分析了2017年3月至2018年1月至2018年1月在2017年3月至2018年1月期间进行的PCC报告的结果。在每个生态学后,PCC被要求选择以下一个或多个选项:改进护理计划,教育,避免不必要的诊断/程序,完全避免推荐或错误的专业,无效。结果PCCS报告了3872个委员会的结果。皮肤病学,内分泌和血液学 - 肿瘤学的疾病最为常见。四分之一的PCC据报道,委员会避免了完全推荐或错误的专业(26.3%),避免了不必要的诊断/程序(26.1%)。在75%的惩治中,PCCS报告了改进的护理计划。五十百分之五十百百分点报道了econsult是教育的。各种实践环境中的讨论PCCS报告了委员会的大量利益。在超过一半的econsults中,PCCS报告称,生态援助避免了不必要的诊断/程序,完全避免了推荐或避免推荐错误的专业。调查结果表明,委员会展示了重要的教育效益,但也可能影响PCC决策,以产生巨大的成本节省潜力和改善患者体验。

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