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从一家四级学术医疗中心看妇产科电子咨询(eConsult)服务的经验。

Experiences in Electronic Consultation (eConsult) Service in Gynecology from a Quaternary Academic Medical Center.

机构信息

Department of Obstetrics, Gynecology & Reproductive Sciences, University of California San Francisco, 480 16th Street, 10th Floor, San Francisco, CA, 94158, USA.

出版信息

J Med Syst. 2021 Apr 6;45(5):58. doi: 10.1007/s10916-021-01732-9.

Abstract

To evaluate an academic institution's implementation of a gynecologic electronic consultation (eConsult) service, including the most common queries, turnaround time, need for conversion to in-person visits, and to demonstrate how eConsults can improve access and convenience for patients and providers. This is a descriptive and retrospective electronic chart review. We obtained data from the UCSF eConsult and Smart Referral program manager. The medical system provided institution-wide statistics. Three authors reviewed and categorized gynecologic eConsults for the last fiscal year. The senior author resolved conflicts in coding. The eConsult program manager provided billing information and provider reimbursement. A total of 548 eConsults were submitted to the gynecology service between July 2017 and June 2020 (4.5% of institutional eConsult volume). Ninety-five percent of the eConsults were completed by a senior specialist within our department. Abnormal pap smear management, abnormal uterine bleeding, and contraception questions were the most common queries. Over half (59.3%) of all inquiries were answered on the same day as they were received, with an average of 9% declined. Gynecology was the 10th largest eConsult provider at our institution in 2020. The present investigation describes one large university-based experience with eConsults in gynecology. Results demonstrate that eConsults permit appropriate, efficient triaging of time-sensitive conditions affecting patients especially in the time of the COVID-19 pandemic. eConsult services provide the potential to improve access, interdisciplinary communication, and patient and provider satisfaction.

摘要

为了评估学术机构实施妇科电子咨询(eConsult)服务的情况,包括最常见的咨询问题、周转时间、是否需要转为面对面就诊,以及展示 eConsult 如何改善患者和医生的就诊便利性。这是一项描述性和回顾性的电子病历审查。我们从 UCSF eConsult 和 Smart Referral 程序管理员那里获取数据。医疗系统提供了全机构范围的统计数据。三位作者审查并对过去一财年的妇科 eConsult 进行了分类。资深作者解决了编码中的冲突。eConsult 项目管理员提供计费信息和医生报销。在 2017 年 7 月至 2020 年 6 月期间,共有 548 份 eConsult 提交给妇科服务部门(占机构 eConsult 总量的 4.5%)。这些 eConsult 中有 95%是由我们部门的高级专家完成的。异常巴氏涂片管理、异常子宫出血和避孕问题是最常见的咨询问题。超过一半(59.3%)的咨询在收到当天就得到了答复,平均有 9%被拒绝。在我们的机构中,2020 年妇科是第十大 eConsult 提供者。本调查描述了一家大型大学附属医院在妇科领域的 eConsult 使用经验。结果表明,eConsult 允许对影响患者的时间敏感情况进行适当、高效的分诊,尤其是在 COVID-19 大流行期间。eConsult 服务有可能改善就诊便利性、跨学科沟通以及患者和医生的满意度。

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