Telehealth Center, University Hospital, Universidade Federal de Minas Gerais, Telehealth Network of Minas Gerais, Belo Horizonte, Brazil.
Department of Medicine, Universidade Federal de São João del-Rei, Divinópolis, Brazil.
Telemed J E Health. 2020 May;26(5):651-658. doi: 10.1089/tmj.2019.0049. Epub 2019 Aug 6.
There is a lack of evidence regarding audits or quality analysis of telehealth strategies in clinical practice. Our aim is to develop and implement a methodology for quality assessment of asynchronous teleconsultations. A random sample of asynchronous teleconsultations performed by the specialists from the Telehealth Network of Minas Gerais (TNMG), a public telehealth service in Brazil, was selected. The responses were evaluated regarding size, objectivity, quality, ethics, courtesy, and grammar, and received a score for each category: 1 = fair, 2 = moderate, and 3 = good. As each domain has a different importance in rating the overall quality of teleconsultation, each one was assigned a different weight, and a final score was calculated. A total of 576 teleconsultations were assessed. Overall, the scores were good or moderate for all items. Only a few cases were classified as fair. Among medical specialties, pediatrics was the one that proportionally received the highest number of fair classifications, and the item "quality of the answers" was the one with highest number of worse classifications for this specialty. Corrective actions were implemented. With regard to the nonmedical specialties, the majority of the items were classified as good or moderate, and in rare cases some items received the fair rating. The methodology showed to be useful to evaluate the teleconsultation service. We established six domains that we considered important components to be assessed. This assessment was essential to identify the priority areas to receive correct actions. It may be easily replicated in other services worldwide.
关于临床实践中远程医疗策略的审核或质量分析，证据不足。我们的目的是开发和实施一种异步远程咨询质量评估方法。从巴西公共远程医疗服务机构米纳斯吉拉斯州远程医疗网络（TNMG）的专家进行的异步远程咨询中随机抽取了一个样本。对回复的大小、客观性、质量、伦理、礼貌和语法进行了评估，并为每个类别分配了一个分数：1=一般，2=中等，3=良好。由于每个领域在远程咨询的整体质量评估中具有不同的重要性，因此为每个领域分配了不同的权重，并计算了最终分数。共评估了 576 次远程咨询。总体而言，所有项目的得分均为良好或中等。只有少数情况被评为一般。在医学专业中，儿科是按比例收到最多一般评分的专业，而对于该专业，“答案质量”这一项的较差评分最多。已经采取了纠正措施。在非医学专业中，大多数项目被评为良好或中等，极少数项目的评分一般。该方法被证明可用于评估远程咨询服务。我们确定了六个我们认为是重要评估组成部分的领域。这种评估对于确定需要采取正确措施的优先领域至关重要。它可以在世界范围内的其他服务中轻松复制。
