Evaluating electronic referrals for specialty care at a public hospital.
Evaluating electronic referrals for specialty care at a public hospital.
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DOI：
10.1007/s11606-010-1402-1
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发表时间：
2010-10
影响因子：
5.7
通讯作者：
Kushel, Margot B.
中科院分区：
文献类型：
--
作者：
Kim-Hwang, Judy E.;Chen, Alice Hm;Bell, Douglas S.;Guzman, David;Yee, Hal F., Jr.;Kushel, Margot B.
转介临床医生和专科医生之间的沟通不畅可能会导致专科服务的使用效率低下。弗朗西斯科总医院实施了一个电子转诊系统（eReferral），促进转诊和专科临床医生之间的迭代访视前沟通，以改善转诊流程。该研究的目的是确定电子转诊（与纸质转诊相比）对专科转诊的影响。这项研究是基于一个访问为基础的问卷附加到新的病人图表在随机选择的专家诊所会议之前和之后的实施电子转诊。专科医生。调查问卷的重点是自我报告的难以确定转诊问题、转诊是否适当、是否需要和是否可以避免随访。我们收集了505份来自专业临床医生的问卷。使用纸质方法的19.8%的内科和38.0%的外科就诊难以确定转诊原因，而使用电子转诊的11.0%和9.5%（p值0.03和<0.001）。在使用电子转诊的患者中，6.4%和9.8%的医疗和手术转诊使用纸质方法，而2.6%和2.1%被认为不完全合适（p值0.21和0.03）。82.4%和76.2%的纸质转诊内科和外科患者要求随访，而eReferral为90.1%和58.1%（p值0.06和0.01）。纸质方法的内科和外科随访中，32.4%和44.7%的随访被认为是可以避免的，而电子转诊的比例分别为27.5%和13.5%（0.41和<0.001）。使用技术来促进标准化的转诊流程以及转诊临床医生和专家之间的反复沟通，有可能改善初级保健提供者和专家之间的沟通，并提高专科转诊的有效性。
Poor communication between referring clinicians and specialists may lead to inefficient use of specialist services. San Francisco General Hospital implemented an electronic referral system (eReferral) that facilitates iterative pre-visit communication between referring and specialty clinicians to improve the referral process. The purpose of the study was to determine the impact of eReferral (compared with paper-based referrals) on specialty referrals. The study was based on a visit-based questionnaire appended to new patient charts at randomly selected specialist clinic sessions before and after the implementation of eReferral. Specialty clinicians. The questionnaire focused on the self-reported difficulty in identifying referral question, referral appropriateness, need for and avoidability of follow-up visits. We collected 505 questionnaires from speciality clinicians. It was difficult to identify the reason for referral in 19.8% of medical and 38.0% of surgical visits using paper-based methods vs. 11.0% and 9.5% of those using eReferral (p-value 0.03 and <0.001). Of those using eReferral, 6.4% and 9.8% of medical and surgical referrals using paper methods vs. 2.6% and 2.1% were deemed not completely appropriate (p-value 0.21 and 0.03). Follow-up was requested for 82.4% and 76.2% of medical and surgical patients with paper-based referrals vs. 90.1% and 58.1% of eReferrals (p-value 0.06 and 0.01). Follow-up was considered avoidable for 32.4% and 44.7% of medical and surgical follow-ups with paper-based methods vs. 27.5% and 13.5% with eReferral (0.41 and <0.001). Use of technology to promote standardized referral processes and iterative communication between referring clinicians and specialists has the potential to improve communication between primary care providers and specialists and to increase the effectiveness of specialty referrals.
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影响因子：
1.4
作者：
Pizzi, LT;Suh, DC;Nash, DB
通讯作者：
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影响因子：
5.7
作者：
Kim, Yeuen;Chen, Alice Hm;Kushel, Margot B.
通讯作者：
Kushel, Margot B.