Integration of e-consultations into the outpatient care process at a tertiary medical centre
Integration of e-consultations into the outpatient care process at a tertiary medical centre
复制标题
DOI：
10.1177/1357633x14533886
复制
发表时间：
2014-06-01
影响因子：
4.7
通讯作者：
Tulledge-Scheitel, Sidna M.
中科院分区：
文献类型：
--
作者：
North, Frederick;Uthke, Lorraine D.;Tulledge-Scheitel, Sidna M.
电子会诊是一种由专科医生进行的非面对面的异步会诊。梅奥诊所的初级医疗服务提供者使用电子会诊已有数年。我们回顾了2013年前6个月梅奥诊所专科医生进行的电子会诊情况。我们只纳入了源自罗切斯特诊所内部的“内部”电子会诊。在研究期间，梅奥诊所总共完成了3242次电子会诊。在排除那些患者未同意用于研究的会诊后，还剩下3008次电子会诊。我们将内部电子会诊分为8种类型。最常用的类型是最先实施的电子会诊流程：初级医疗服务提供者到专科医生的电子会诊以及专科医生到专科医生的电子会诊，占总数的74%。随着这两种电子会诊被广泛使用，工作人员发现电子会诊流程可进行调整以满足特定的临床实践需求，于是又出现了另外6种电子会诊类型。例如，专科内部电子会诊和外科电子会诊占总数的16%。电子会诊似乎改善了获取专科医生服务的途径，并且在需要及时的专家意见时被整合到医疗护理流程中。随着电子会诊的发展，制定一套标准的、定义明确的术语以比较不同临床实践中这些流程的结果将是很重要的。
An e-consultation is an asynchronous consultation performed by a specialist without a face-to-face patient visit. E-consultations have been available to primary care providers at the Mayo Clinic for several years. We reviewed e-consultations performed by specialists at the Mayo Clinic for the first six months of 2013. We included only "internal'' e-consultations, originating from within the Rochester practice. During the study period a total of 3242 e-consultations were completed at the Mayo Clinic. After excluding those relating to patients who did not give research consent, 3008 e-consultations remained. We categorized our internal e-consultations into eight types. The most frequently used types were the first e-consultation processes to be implemented: the primary care to specialist e-consultation and the specialist to specialist e-consultation, accounting for 74% of the total. As these two types of e-consultation became widely used, the staff discovered that the e-consultation process could be adapted to meet specific practice needs and six more e-consultation types emerged. For example, intra-specialty e-consultations and surgical e-consultations accounted for 16% of the total. E-consultations appear to have improved access to specialists, and they are integrated into care processes when timely expert opinions are needed. As e-consultations evolve, it will be important to develop a standard, well-defined terminology to compare outcomes of these processes across practices.