在安大略省通过对eConsult (TReC) 的分类推来改善专业护理的准入:RE-AIM评估
Brynn O'Dwyer1, Erin Keely1,2,3, Ellen B Goldbloom4,5,6
1eConsult Centre of Excellence, The Ottawa Hospital, Ottawa, Canada.
Studies in health technology and informatics
|February 13, 2026
概括
在加拿大三个医院成功扩展了对eConsult (TReC) 的选推,大大减少了专家等待时间,改善了获得护理的机会. 这个创新的系统证明了提供者和患者的高满意度,为医疗保健挑战提供了具有成本效益的解决方案.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 数字健康实施方案
- 获得医疗保健和公平的机会.
背景情况:
- 加拿大医疗保健在获得专科护理方面面临重大挑战,导致长时间的等待时间和不理想的患者结果.
- 太华医院开发了对eConsult进行选推 (TReC),以将专家建议纳入现有的健康信息系统 (HIS) 和推工作流.
- 选择RE-AIM框架是为了系统地评估TReC在多个医疗保健机构的实施和影响.
研究的目的:
- 评估三家加拿大主要医院的eConsult (TReC) 系统的实施,有效性和可扩展性.
- 评估TReC对专业护理获取,响应时间,成本和用户接受度的影响.
- 确定TReC在改善及时和公平获得专家咨询方面的潜力.
主要方法:
- RE-AIM框架指导了评估,评估了覆盖范围,有效性,采用,实施和维护.
- 数据是通过行政记录和对患者和医疗保健提供者进行的调查收集的,这些数据来自太华医院 (TOH),妇女学院医院 (WCH) 和东安大略省儿童医院 (CHEO).
- 关键指标包括专家参与人数,eConsult量,中位响应时间,案件成本,以及关于建议可行性和感知访问改进的用户满意度等级.
主要成果:
- 在三个地点成功实施了TReC,有显著的专家参与 (160在TOH,22在WCH,26在CHEO) 和高的eConsult量 (>10,000在TOH).
- 电子咨询的中位响应时间从2至8天不等,远远短于安大略省面对专家的23周平均时间.
- 该系统具有很高的可接受性,84-91%的提供者发现建议是可行的,70%的患者感到担忧得到解决,91%的专家认为获得改善,所有这些都是以每例37加元的低中位成本.
结论:
- 诊断对eConsult (TReC) 转诊系统已成功扩展到多家医院,大大提高了及时获得专业护理的机会.
- 在推提供者,患者和专家中,高水平的用户接受度强调了TReC的有效性和更广泛采用潜力.
- 这些发现支持TReC的扩展,作为改善安大略省和可能面临类似挑战的其他地区医疗保健准入和公平的战略.
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