Pilot Study of Providing Online Care in a Primary Care Setting
Pilot Study of Providing Online Care in a Primary Care Setting
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DOI：
10.4065/mcp.2010.0145
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发表时间：
2010-08-01
影响因子：
8.9
通讯作者：
Bachman, John W.
中科院分区：
文献类型：
--
作者：
Adamson, Steven C.;Bachman, John W.
目的：为了研究在初级保健setting.Patients和方法中使用电子就诊：在明尼苏达州罗切斯特的马约诊所的家庭医学部进行了一项使用互联网进行在线护理（“电子就诊”）的试点研究。该部门的患者预先注册了该服务，然后可以使用在线门户网站与他们的初级保健医生进行咨询。从2007年11月1日至2009年10月31日，监测在线门户网站的使用情况，并收集数据。结果：在2年期间，4282名患者注册了该服务。患者进行了2531次在线访问，并为1159名患者开具了账单。电子访问主要由妇女在工作时间提交，涉及294种不同的情况。在2531次电子访问中，62次（2%）包括上传的照片，411次（16%）用可计费的遭遇取代了不可计费的电话协议。在1012例（40%）的电子访问不必要的办公室访问，在324例（13%），病人被要求安排预约面对面encounter.CONCLUSION：虽然范围有限，据我们所知，这是最大的研究在线访问初级保健使用结构化的历史，允许病人输入任何问题，并在适当的时候向病人收费。通过在线护理治疗的可能条件的范围是广泛的，并通过使用结构化的历史进行最少的信息交换来管理。以前作为免费服务或由护士分诊和受医疗事故（协议）的过程现在被记录和计费。
OBJECTIVE: To study the use of e-visits in a primary care setting.PATIENTS AND METHODS: A pilot study of using the Internet for online care ("e-visits") was conducted in the Department of Family Medicine at Mayo Clinic in Rochester, MN. Patients in the department preregistered for the service, and then were able to use the online portal for consultations with their primary care physician. Use of the online portal was monitored and data were collected from November 1, 2007, through October 31, 2009.RESULTS: During the 2-year period, 4282 patients were registered for the service. Patients made 2531 online visits, and billings were made for 1159 patients. E-visits were submitted primarily by women during working hours and involved 294 different conditions. Of the 2531 e-visits, 62 (2%) included uploaded photographs, and 411 (16%) replaced nonbillable telephone protocols with billable encounters. The e-visits made office visits unnecessary in 1012 cases (40%); in 324 cases (13%), the patient was asked to schedule an appointment for a face-to-face encounter.CONCLUSION: Although limited in scope, to our knowledge this is the largest study of online visits in primary care using a structured history, allowing the patient to enter any problem, and billing the patient when appropriate. The extent of conditions possible for treatment by online care was far-ranging and was managed with a minimum of message exchanges by using structured histories. Processes previously given as a free service or by nurse triage and subject to malpractice (protocols) were now documented and billed.