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针对 COVID-19 大流行的靶向应对:分析远程咨询在常规皮肤科转诊分诊和管理中的效果。

A targeted response to the COVID-19 pandemic: analysing effectiveness of remote consultations for triage and management of routine dermatology referrals.

机构信息

Department of Dermatology, Portsmouth Hospitals NHS Trust, Portsmouth, Hampshire, UK.

Faculty of Science, School of Pharmacy and Biomedical Sciences, University of Portsmouth, Portsmouth, Hampshire, UK.

出版信息

Clin Exp Dermatol. 2020 Dec;45(8):1047-1050. doi: 10.1111/ced.14289. Epub 2020 Aug 29.

Abstract

During the UK's COVID-19 pandemic lockdown there was national guidance to suspend routine dermatology work. As a consequence, over 800 patient appointments in a district general dermatology department were temporarily suspended. Remote consultations were carried out to triage and manage referrals, via telephone or video consultations. Data were prospectively recorded on 488 patient interactions. Outcomes included advice/treatment, discharge, surgery or clinic review; 25% of patients were either uncontactable or their problem had resolved. Over a third of referrals were discharged with advice/treatment initiated remotely; 56% of referred dermatoses required further clinical review; 25% of lesion referrals were booked directly to surgery. This process was time-intensive for the clinicians involved, and triage mechanisms could be improved. Sufficient referral information allows remote diagnosis; implementation of management plans and appropriate discharge of patients. This process has been shown to be feasible, and may be a temporary solution for other COVID-19 impacted dermatology departments.

摘要

在英国 COVID-19 大流行封锁期间,有国家指南建议暂停常规皮肤科工作。因此,一个地区普通皮肤科部门的 800 多个患者预约被暂时暂停。通过电话或视频咨询进行远程咨询以进行分诊和管理转诊。对 488 次患者就诊进行了前瞻性记录。结果包括建议/治疗、出院、手术或诊所复查;25%的患者无法联系或问题已解决。超过三分之一的转诊患者通过远程方式获得建议/治疗后出院;需要进一步临床复查的转诊皮肤病占 56%;25%的病变转诊直接预约手术。这一过程对参与的临床医生来说时间耗费大,分诊机制可以得到改善。足够的转诊信息可以实现远程诊断;实施管理计划和适当的患者出院。这一过程已经被证明是可行的,并且可能是受 COVID-19 影响的其他皮肤科部门的临时解决方案。

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