Uldal S B, Nikishova E, Rakova N, Mariandyshev A, Bye S M, Nisovtszevat N
Norwegian Centre for Telemedicine, University Hospital of North-Norway, Tromsø, Norway.
Int J Tuberc Lung Dis. 2005 Dec;9(12):1367-72.
Ten health care institutions in north-west Russia.
To improve the management of tuberculosis patients using e-mail.
Over an 18-month period, all outgoing and incoming e-mails at the Arkhangelsk Regional Tuberculosis Centre were saved and categorised. All e-mails relating to distance learning were logged, and a consensus panel discussed and answered questionnaires regarding 47 e-mail-based second opinions.
e-mail was found to speed up communication and increase the availability of specialist advice. Distance learning was positively received, but was used in moderation. For six of 47 consultations (13%), the consensus panel deemed that fast access to a second opinion saved lives. In 30 consultations (64%), the patient was saved a round trip to a specialist centre. In 24 consultations (51%), the panel considered that the patients had started correct treatment between 1 week and 1 month earlier than without e-mail access. In 11 of these consultations, 23% of the total, the patient was found to be infectious. The learning effects of second opinions were recognised.
General e-mail use and the second opinion service in particular were found to be useful. Further studies are needed to investigate the advantages and disadvantages of using e-mail as a tool in the management of TB.
俄罗斯西北部的十家医疗机构。
利用电子邮件改善结核病患者的管理。
在18个月的时间里，阿尔汉格尔斯克地区结核病中心保存并分类了所有收发的电子邮件。记录了所有与远程学习相关的电子邮件，一个共识小组讨论并回答了关于47份基于电子邮件的二次诊断意见的问卷。
发现电子邮件加快了沟通速度并增加了专家建议的可获取性。远程学习受到好评，但使用频率适中。在47次会诊中，有6次（13%），共识小组认为快速获得二次诊断意见挽救了生命。在30次会诊中（64%），患者无需前往专科中心就诊。在24次会诊中（51%），小组认为患者比没有电子邮件服务的情况下提前1周到1个月开始了正确治疗。在其中11次会诊中，占总数的23%，发现患者具有传染性。二次诊断意见的学习效果得到认可。
发现一般电子邮件的使用，尤其是二次诊断意见服务很有用。需要进一步研究以调查使用电子邮件作为结核病管理工具的优缺点。
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