Najafi Nader, Harrison James D, Duong Jonathan, Greenberg Anya, Cheng Hugo Quinny
Division of Hospital Medicine, University of California San Francisco, San Francisco, CA.
University of California San Francisco Medical Center, San Francisco, CA.
J Hosp Med. 2017 May;12(5):332-334. doi: 10.12788/jhm.2740.
Although the use of electronic consultations (e-consults) in the outpatient setting is commonplace, there is little evidence of their use in the inpatient setting. Often, the only choice hospitalists have is between requesting a time-consuming in-person consultation or requesting an informal, undocumented "curbside" consultation. For a new, remote hospital in our healthcare system, we developed an e-consult protocol that can be used to address simple consultation questions. In the first year of the program, 143 e-consults occurred; the top 5 consultants were infectious disease, hematology, endocrinology, nephrology, and cardiology. Over the first 4 months, no safety issues were identified in chart review audits; to date, no safety issues have been identified through the hospital's incident reporting system. In surveys, hospitalists were universally pleased with the quality of e-consult recommendations, though only 43% of consultantsagreed. With appropriate care for patient selection, e-consults can be used to safely and efficiently provide subspecialty expertise to a remote inpatient site Journal of Hospital Medicine 2017;12:332-334.
尽管在门诊环境中使用电子会诊（e-会诊）很常见，但在住院环境中的使用证据却很少。通常，住院医师唯一的选择是在要求耗时的面对面会诊或要求进行非正式的、无记录的“床边”会诊之间做出抉择。对于我们医疗系统中的一家新建偏远医院，我们制定了一种可用于解决简单会诊问题的电子会诊方案。在该项目的第一年，共进行了143次电子会诊；排名前5的会诊科室是传染病科、血液科（或血液学）、内分泌科、肾内科和心内科（或心脏病学）。在最初的4个月里通过病历审查审计未发现安全问题；截至目前，通过医院的事件报告系统也未发现安全问题。在调查中，住院医师对电子会诊建议的质量普遍满意，不过只有43%的会诊医师表示认同。通过对患者选择进行适当把关，电子会诊可用于安全、高效地为偏远住院部提供专科知识《医院医学杂志》2017年；12:332 - 334。
