Ahmed Shahzad, Almario Christopher V, Chey William D, Robbins Lori A, Chang Bianca, Ahn Joseph, Ko Jeffrey, Gu Phillip, Siu Alvin, Spiegel Brennan M R
a Department of Medicine , Cedars-Sinai Medical Center , Los Angeles , CA , USA.
b Division of Digestive and Liver Diseases , Cedars-Sinai Medical Center , Los Angeles , CA , USA.
Inform Health Soc Care. 2019 Jan;44(1):105-113. doi: 10.1080/17538157.2018.1437041. Epub 2018 Mar 6.
Little is known about the agreement between referring providers' reason for specialty evaluation and patients' understanding of why they are referred for consultation. Here, we compared the reason for consult (RFC) documented by referring providers during usual care vs. the perceived RFC independently reported by patients through an e-portal just prior to the specialist visit.
We performed an observational study among patients referred for gastrointestinal (GI) evaluation. Patients referred to the specialty clinic submitted their self-reported RFC using an online patient agenda form prior to their visit. Therefore, each participant had a referring provider- and patient-documented RFC. Blinded physicians reviewed the RFCs in random order using a priori coding criteria. We then compared whether the provider and patient RFC pairs were concordant (i.e., ≥1 clinical topic[s] in the RFCs matched).
Sixty patients completed the e-portal prior to their visit, leading to 60 provider-patient RFC pairs. The RFC pairs were concordant in only 52% of cases.
There is poor agreement between referring providers' reason for GI referral and patients' understanding of why they are visiting the clinic. Future research examining whether electronic patient agenda forms impact diagnostic and management precision, patient satisfaction, and healthcare utilization is warranted.
关于转诊提供者进行专科评估的原因与患者对自己为何被转诊进行会诊的理解之间的一致性,目前所知甚少。在此,我们比较了转诊提供者在常规护理过程中记录的会诊原因(RFC)与患者在专科就诊前通过电子门户独立报告的感知RFC。
我们对转诊进行胃肠道(GI)评估的患者进行了一项观察性研究。转诊至专科诊所的患者在就诊前使用在线患者日程表提交了他们自我报告的RFC。因此,每位参与者都有一份转诊提供者记录的和患者记录的RFC。不知情的医生使用先验编码标准以随机顺序审查RFC。然后,我们比较了提供者和患者的RFC对是否一致(即,RFC中的≥1个临床主题相匹配)。
60名患者在就诊前完成了电子门户操作,从而产生了60对提供者-患者RFC对。RFC对仅在52%的病例中一致。
转诊提供者进行GI转诊的原因与患者对自己为何就诊的理解之间的一致性较差。有必要进行未来研究,以检验电子患者日程表是否会影响诊断和管理的准确性、患者满意度以及医疗保健的利用情况。