Department of Orthopaedics, West Virginia University, PO Box 9196, Morgantown, WV 26506-9196, USA.
Department of Neurosurgery, West Virginia University, PO Box 9183, Morgantown, WV 26506-9183, USA.
Spine J. 2021 May;21(5):779-784. doi: 10.1016/j.spinee.2021.01.006. Epub 2021 Jan 9.
Ambulatory spine referral triage must be optimized to improve both quality of care and access to specialists.
To evaluate cost savings in an existing model of telemedicine/electronic-triage for ambulatory spine referrals.
STUDY DESIGN/SETTING: Retrospective review. Institutional spine center.
All patients/referrals made to the institutional spine center of a tertiary medical center from 2011 to 2014 were included in the data analysis.
Cost savings and efficiency was evaluated based upon intake to appointment time, rate of referral to surgeons versus nonoperative providers, additional testing required, and extrapolated cost savings based on estimated avoidance of unnecessary office visits and travel.
All ambulatory spine referrals electronically triaged (E-triaged) from 2011 to 2014 were analyzed. The E-triage database was mined for data from intake until triage completion. Hospital electronic medical record system was mined for data on initial clinic visit, tests ordered, follow-up appointments, and presence of surgical encounters. Financial savings from avoiding unnecessary visits were estimated.
There were 16,174 records created from 2011 to 2014, of which 10,832 were E-triaged by spine surgeons. E-triage generated 3,718 nonoperative provider visits within our healthcare system. The "saved" surgical consult that was avoided resulted in total estimated savings of $793,835 to the patient population; 4,446 patients were deemed surgical and were offered appointments with a spine surgeon.
Appropriate triage of ambulatory spine referrals improves access and quality of care. E-triage resulted in $800,000 cost savings. Further studies are required to fully evaluate the effects of an E-triage system on ambulatory spinal care.
门诊脊柱转诊分诊必须优化，以提高医疗质量和获得专家服务的机会。
评估电子分诊模式下的远程医疗用于门诊脊柱转诊的成本节约。
研究设计/环境：回顾性研究。机构脊柱中心。
所有于 2011 年至 2014 年转诊至三级医疗中心机构脊柱中心的患者/转诊患者均纳入数据分析。
根据就诊到预约时间、转诊至外科医生与非手术提供者的比例、所需的额外检查以及根据估计避免不必要的门诊就诊和旅行来推断的节省成本，评估成本节约和效率。
分析 2011 年至 2014 年电子分诊的所有门诊脊柱转诊。从电子分诊数据库中挖掘数据，直至分诊完成。从医院电子病历系统中挖掘初始诊所就诊、检查订单、随访预约和手术就诊的数据。估计避免不必要就诊带来的经济节省。
2011 年至 2014 年共创建了 16174 条记录，其中 10832 条由脊柱外科医生进行电子分诊。电子分诊在我们的医疗系统中产生了 3718 次非手术提供者就诊。避免的“节省”的手术咨询总共为患者群体节省了 793835 美元；4446 名患者被认为需要手术，并安排与脊柱外科医生预约。
适当的门诊脊柱转诊分诊可改善获得医疗服务的机会和医疗质量。电子分诊节省了 80 万美元的成本。需要进一步的研究来全面评估电子分诊系统对门诊脊柱护理的影响。
