BMC Med Inform Decis Mak - Comparing virtual consults to traditional consults using an electronic health record: an observational case-control study.

Tópicos

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Resumo

CKGROUND: Patients have typically received health care through face-to-face encounters. However, expansion of electronic communication and electronic health records (EHRs) provide alternative means for patient and physicians to interact. Electronic consultations may complement regular healthcare by providing "better, faster, cheaper" processes for diagnosing, treating, and monitoring health conditions. Virtual consultation between physicians may provide a method of streamlining care, potentially saving patients the time and expense of added visits. The purpose of this study was to compare physician usage and patient satisfaction with virtual consultations (VCs) with traditional consultations (TCs) facilitated within an EHR.METHODS: We conducted an observational case-control survey study within Kaiser Permanente, Colorado. A sample of patients who had VCs requested by physicians (N = 270) were matched with patients who had TCs requested by physicians (N = 270), by patient age, gender, reason for the consult, and specialty department. These patients (VC and TC), were invited to participate in a satisfaction survey. In addition, 205 primary care physicians who submitted a VC or TC were surveyed.RESULTS: During the study period, 58,146 VC or TC were requested (TC = 96.3%). Patients who completed a satisfaction survey (267 out of 540 patients, 49.4% response rate) indicated they were satisfied with their care, irrespective of the kind of consult (mean 10-point Likert score of 8.5). 88 of 205 primary care physicians surveyed (42.9%) returned at least one survey; VC and TC survey response rates and consulted departments were comparable (p = 0.13). More TCs than VCs requested transfer of patient care (p = 0.03), assistance with diagnosis (p = 0.04) or initiating treatment (p =0.04). Within 3 weeks of the consultation request, 72.1% of respondents reported receiving information from VCs, compared with 33.9% of the TCs (p < 0.001). Utility of information provided by consultants and satisfaction with consultations did not differ between VCs and TCs.CONCLUSIONS: Referring physicians received information from consultants more quickly from VCs compared with TCs, but the value and application of information from both types of consultations were similar. VCs may decrease the need for face-to-face specialty encounters without a decrease in the patient's perception of care.

Resumo Limpo

ckground patient typic receiv health care facetofac encount howev expans electron communic electron health record ehr provid altern mean patient physician interact electron consult may complement regular healthcar provid better faster cheaper process diagnos treat monitor health condit virtual consult physician may provid method streamlin care potenti save patient time expens ad visit purpos studi compar physician usag patient satisfact virtual consult vcs tradit consult tcs facilit within ehrmethod conduct observ casecontrol survey studi within kaiser permanent colorado sampl patient vcs request physician n match patient tcs request physician n patient age gender reason consult specialti depart patient vc tc invit particip satisfact survey addit primari care physician submit vc tc surveyedresult studi period vc tc request tc patient complet satisfact survey patient respons rate indic satisfi care irrespect kind consult mean point likert score primari care physician survey return least one survey vc tc survey respons rate consult depart compar p tcs vcs request transfer patient care p assist diagnosi p initi treatment p within week consult request respond report receiv inform vcs compar tcs p util inform provid consult satisfact consult differ vcs tcsconclus refer physician receiv inform consult quick vcs compar tcs valu applic inform type consult similar vcs may decreas need facetofac specialti encount without decreas patient percept care

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