Dell Medical School, University of Texas at Austin, USA.
CommUnityCare Austin, USA.
J Telemed Telecare. 2022 Sep;28(8):577-582. doi: 10.1177/1357633X20957224. Epub 2020 Sep 20.
The ongoing coronavirus disease 2019 pandemic has forced providers to dramatically scale down in-person clinic visits to enforce social distancing and triage care to the neediest patients. We describe our five-month experience with a hybrid gastroenterology electronic consultation programme starting in 2019 in which we perform electronic consultations for every referral regardless of indication as well as directly initiate telephone-based telehealth visits with patients without the need for in-person clinic. Over five consecutive months, 1243 hybrid electronic consultations were performed with 356 (29%) resulting in a clinic appointment. The remaining 887 (71%) electronic consultations were resolved without need for a clinic visit. Five hundred and fourteen (41%) electronic consultations resulted in a directly scheduled procedure without clinic appointment. Eighty-five per cent of electronic consultations were performed on the same day of referral and 98% of electronic consultations were completed in under 20 min. A hybrid electronic consultation model which pre-emptively reviews all outpatient referrals streamlines access to specialty care. Such a model may be implemented rapidly during the current coronavirus disease 2019 pandemic as well as serve as a platform for long-term improvement in efficiency of care.
正在持续的 2019 冠状病毒病大流行迫使医疗服务提供者大幅减少门诊就诊，以执行社交距离措施并对最急需的患者进行分诊护理。我们描述了我们从 2019 年开始实施的混合式胃肠病电子咨询计划的五个月经验，在该计划中，我们对每一个转介进行电子咨询，无论其指征如何，并且直接为无需门诊就诊的患者启动基于电话的远程医疗访问。在连续五个月中，共进行了 1243 次混合式电子咨询，其中 356 次（29%）导致了门诊预约。其余 887 次（71%）电子咨询无需门诊就诊即可解决。514 次（41%）电子咨询直接安排了无需门诊预约的程序。85%的电子咨询在转介当天进行，98%的电子咨询在 20 分钟内完成。一种混合式电子咨询模式可以预先审查所有门诊转介，从而简化获得专科护理的途径。在当前的 2019 冠状病毒病大流行期间，可以迅速实施这种模式，并且可以作为长期提高护理效率的平台。
