通过 Champlain BASE eConsult 服务改善获得辅助医疗专业人员的途径：加拿大的一项横断面研究。
Improving access to allied health professionals through the Champlain BASE eConsult service: a cross-sectional study in Canada.
机构信息
CT Lamont Primary Health Care Research Centre, Ottawa, Canada.
Department of Medicine, University of Ottawa, Ottawa, Canada.
出版信息
Br J Gen Pract. 2017 Nov;67(664):e757-e763. doi: 10.3399/bjgp17X693125. Epub 2017 Oct 9.
BACKGROUND
Allied health services are an important part of providing effective team-based care. The Champlain BASE™ (Building Access to Specialists through eConsultation) eConsult service facilitates quick and secure communication between primary care providers (PCPs) and allied health professionals (AHPs).
AIM
To assess the eConsult service's ability to improve access to advice from AHPs.
DESIGN AND SETTING
A cross-sectional study was carried out on all cases submitted to AHPs through the eConsult service between April 2011 and May 2016. The service covers Ottawa, Canada, and its surrounding rural communities.
METHOD
A descriptive overview of all cases submitted to allied health services was conducted. Utilisation and survey metrics for AHP eConsults were compared with those sent to medical specialties, in order to understand the potential differences and generalisability of eConsult access beyond the traditional medical specialty referral.
RESULTS
PCPs submitted 127 cases to nine allied health specialties during the study period. The most popular specialty was clinical pharmacist, which received an average of 1.5 cases per month. The median specialist response time was 2.1 days (interquartile range [IQR] 0.7-5.3 days, range 0.01-14.2 days) versus 0.9 days (IQR 0.2-3.4 days, range 0-49.5 days) for medical specialties. PCPs received advice for a new or additional course of action in 70% (versus 58% for medical specialties) of cases. They rated the service as being of high or very high value for their patients in 88% of cases (versus 93% for medical specialties), and for themselves in 89% (94% for medical specialties) of cases.
CONCLUSION
The eConsult service has demonstrated the ability to support prompt communication between PCPs and AHPs, improving patients' access to AHP care. Given the importance of AHPs in providing primary care, allied health services should be offered in the menu of specialties available through electronic consultation services.
背景
辅助医疗服务是提供高效团队医疗服务的重要组成部分。 Champlain BASE（通过电子咨询为专科医生提供服务）电子咨询服务促进了初级保健提供者（PCP）与辅助医疗专业人员（AHP）之间的快速、安全的沟通。
目的
评估电子咨询服务提高获取 AHP 建议的能力。
设计和设置
对 2011 年 4 月至 2016 年 5 月期间通过电子咨询服务提交给 AHP 的所有病例进行了横断面研究。该服务覆盖加拿大渥太华及其周边农村社区。
方法
对提交给辅助医疗服务的所有病例进行了描述性概述。比较了 AHP 电子咨询的使用和调查指标与医学专业的电子咨询指标，以了解电子咨询的潜在差异和在传统医学专业转诊之外的普及程度。
结果
在研究期间，PCP 向九个辅助医疗专业提交了 127 例病例。最受欢迎的专科是临床药师，平均每月收到 1.5 例。专科医生的平均回复时间为 2.1 天（四分位距 [IQR] 0.7-5.3 天，范围 0.01-14.2 天），而医学专业的回复时间为 0.9 天（IQR 0.2-3.4 天，范围 0-49.5 天）。在 70%（医学专业为 58%）的病例中，PCP 获得了新的或额外的治疗方案建议。在 88%（医学专业为 93%）的病例中，PCP 认为该服务对其患者非常有价值或高价值，在 89%（医学专业为 94%）的病例中，PCP 认为该服务对自己非常有价值或高价值。
结论
电子咨询服务已证明能够支持 PCP 与 AHP 之间的快速沟通，改善患者获得 AHP 护理的机会。鉴于 AHP 在提供初级保健方面的重要性，辅助医疗服务应在电子咨询服务提供的专科菜单中提供。
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