患者发起的存储和转发远程皮肤病学:一个单一的实践经验
Clayton B Green1, Chavy Chiang2, Molly E Plovanich1
1Drs. Green and Plovanich are with the Department of Dermatology at the University of Rochester Medical Center in Rochester, New York.
The Journal of clinical and aesthetic dermatology
|August 28, 2023
概括
电子咨询 (eConsults) 有效地解决了超过一半的患者皮肤病问题,从而大大节省了成本. 这种方法提供了一个可行的替代体验,证明了适度的诊断可靠性.
科学领域:
- 皮肤病学 皮肤病学
- 医疗信息学 医疗信息学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 通过电子健康记录 (EHR) 提交的患者图像越来越多地用于医疗咨询.
- 评估这些电子咨询 (eConsults) 的有效性和成本效益对于优化医疗保健服务至关重要.
研究的目的:
- 确定通过电子健康记录系统提交的患者投诉的处理方式.
- 估计与电子解决的eConsults相关的成本节约.
- 评估eConsults的诊断一致性和评估者之间的可靠性.
主要方法:
- 通过Epic EHR提交的85名患者的112张图像的回顾性图表审查.
- 将eConsult决议分类为电子解决方案或面对面访问要求.
- 基于避免办公室访问等效的成本节约分析.
- 使用Krippendorff的alpha评估诊断一致性和评价者之间的可靠性.
主要成果:
- 53.6%的电子咨询是通过电子方式解决的,其中38.3%涉及放心,61.7%涉及处方管理.
- 通过电子方式解决的遭遇节省了6,717.25美元的成本.
- 诊断一致性为78.6%,对面预约的必要性达成一致63.4%.
- 评价者之间的可靠性 (克里多夫α) 为0.773,表明可靠性适度.
结论:
- 患者提交的电子咨询是解决大量皮肤病问题的可行方法.
- 电子咨询为医疗保健实践提供了可证明的成本节约.
- 虽然诊断一致性是合理的,但评价者之间的可靠性表明需要进一步改进eConsult评估协议.
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