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电子咨询服务为初级保健医生和专家带来的独特教育机会。

Unique Educational Opportunities for PCPs and Specialists Arising From Electronic Consultation Services.

机构信息

E.J. Keely is full professor, Department of Medicine, Faculty of Medicine, University of Ottawa, and chief, Division of Endocrinology and Metabolism, Ottawa Hospital, Ottawa, Ontario, Canada, and specialist lead, Champlain BASE eConsult Service.D. Archibald is assistant professor, Department of Family Medicine, Faculty of Medicine, University of Ottawa, and education researcher, C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, Ontario, Canada.D.S. Tuot is assistant professor, Department of Medicine, University of California, San Francisco; Division of Nephrology, San Francisco General Hospital; and director, San Francisco General Hospital eReferral program and University of California, San Francisco, Center for Innovation in Access and Quality, San Francisco, California.H. Lochnan is associate professor, Department of Medicine, and assistant dean, Continuing Professional Development and Education Programming, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.C. Liddy is associate professor, Department of Family Medicine, Faculty of Medicine, University of Ottawa, clinician investigator, C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, Ontario, Canada, and primary care lead, Champlain BASE eConsult Service.

出版信息

Acad Med. 2017 Jan;92(1):45-51. doi: 10.1097/ACM.0000000000001472.

Abstract

Health care reform should be driven by the goals of better patient experience, improved population health, lower per capita costs, and improved provider satisfaction. Electronic consultation (eConsult) services have been adopted by several jurisdictions in the United States, Canada, and Europe to improve access to specialists by primary care providers (PCPs) and are being heralded as a key component for delivery of coordinated care. The primary intent of an eConsult service is to provide PCPs with efficient, timely, direct access to specialist expertise to help guide the management of their patients, reduce the need for unnecessary face-to-face specialty consultations, and improve the quality of the initial face-to-face consultation when needed, through the preconsultative communication.In addition to improving access to care, eConsult services have been praised by PCPs and specialists for their educational value, in particular their ability to enrich practice-based learning. Less recognized, but equally important from the educational perspective, include the abilities of eConsult programs to promote reflection by PCPs and specialists, improve collegiality and professionalism between primary and specialist care, inform continuing professional development activities and maintenance of certification, and enhance training programs' teaching of effective communication and care coordination.As eConsult services become increasingly available, the medical community must leverage the educational opportunities inherent in eConsult programs to further improve the delivery of coordinated specialty care. The educational role of eConsults should be considered as a priority outcome in their evaluation and must be highlighted and optimized in next iterations of eConsult systems design.

摘要

医疗改革应以改善患者体验、提高人口健康水平、降低人均成本和提高医疗服务提供者满意度为目标。电子咨询(eConsult)服务已在美国、加拿大和欧洲的几个司法管辖区采用,以改善初级保健提供者(PCP)获得专家的机会,并被誉为提供协调护理的关键组成部分。eConsult 服务的主要目的是为 PCP 提供高效、及时、直接的专家专业知识,以帮助指导他们管理患者,减少不必要的面对面专科咨询的需求,并在需要时提高初始面对面咨询的质量,通过预咨询沟通来实现。除了改善医疗服务的可及性之外,eConsult 服务还因其教育价值而受到 PCP 和专家的赞扬,特别是其丰富实践学习的能力。但从教育角度来看,同样重要但较少被认识到的是,eConsult 计划能够促进 PCP 和专家的反思,改善初级保健和专科保健之间的合作和专业精神,为继续教育活动和认证维护提供信息,并加强培训计划对有效沟通和协调护理的教学。随着 eConsult 服务的日益普及,医疗界必须利用 eConsult 计划中固有的教育机会,进一步改善协调专科护理的提供。在评估中应将 eConsults 的教育作用视为优先结果,并在下一迭代的 eConsult 系统设计中突出和优化。

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