e-Consultation Improves Efficacy in Thoracic Surgery Outpatient Clinics

Area of Science:

• Thoracic Surgery
• Medical Informatics
• Healthcare Management

Background:

• Outpatient clinics in thoracic surgery face challenges in optimizing patient evaluation and treatment pathways.
• The integration of telemedicine, specifically videoconferencing, offers potential solutions for improving clinical efficiency.
• Assessing the impact of systematic versus occasional case discussions via videoconferencing is crucial for service improvement.

Purpose of the Study:

• To analyze the impact of systematic versus occasional videoconferencing case discussions on the efficiency of thoracic surgery outpatient clinics.
• To evaluate changes in outpatient clinic efficiency over a six-year period, comparing two distinct discussion protocols.

Main Methods:

• A retrospective, comparative study design was employed, analyzing data from two periods: 2008-2010 (occasional videoconferencing) and 2011-2013 (weekly videoconferencing).
• Data on e-consultations, in-person outpatient visits, and surgeries were collected from electronic databases.
• An efficiency index (operated cases/first outpatient visit) was calculated and compared between groups using the Wilcoxon test.

Main Results:

• The number of patients evaluated annually in outpatient clinics decreased from 563 in the occasional group to 464 in the systematic group.
• The median number of cases discussed via videoconferencing significantly increased from 42 to 136 cases per year.
• The efficiency index improved from 0.7 to 0.87 (P=.04), indicating a higher proportion of operated cases per outpatient visit in the systematic videoconferencing group.

Conclusions:

• Systematic, regular videoconferencing discussions of patient cases positively impact the efficiency of thoracic surgery outpatient clinics.
• This integrated approach enhances the conversion of outpatient visits to surgical procedures, signifying improved clinical decision-making and resource utilization.