将虚拟医生问诊整合到省级 8-1-1 健康信息电话服务中：对卑诗省健康热线紧急 iDoctor 辅助服务（HEiDi）的描述性研究。

Integration of virtual physician visits into a provincial 8-1-1 health information telephone service during the COVID-19 pandemic: a descriptive study of HealthLink BC Emergency iDoctor-in-assistance (HEiDi).

机构信息

Digital Emergency Medicine (Ho, Novak Lauscher, Stewart), Department of Emergency Medicine, and Department of Emergency Medicine (Ho, Novak Lauscher, Abu-Laban, Grafstein, Christenson), Faculty of Medicine, The University of British Columbia; BC Emergency Medicine Network (Ho, Abu-Laban, Christenson); Department of Emergency Medicine (Scheuermeyer), St Paul's Hospital and The University of British Columbia; Centre for Health Evaluation and Outcome Sciences (Scheuermeyer), Vancouver, BC; HealthLink BC (Sundhu), Primary Care Division, Ministry of Health, Victoria, BC

出版信息

CMAJ Open. 2021 Jun 15;9(2):E635-E641. doi: 10.9778/cmajo.20200265. Print 2021 Apr-Jun.

DOI:10.9778/cmajo.20200265

PMID:34131026

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8248563/

Abstract

BACKGROUND

British Columbia, like many jurisdictions, has a health information telephone service (8-1-1) to provide callers with information by registered nurses and help them decide whether to attend an emergency department or primary care clinic, or manage their concern at home. We describe a new service, HealthLink BC Emergency iDoctor-in-assistance (HEiDi), that partnered physicians available by videoconferencing with 8-1-1 registered nurses to support callers.

METHODS

From Apr. 6 to Aug. 2, 2020, all callers to the 8-1-1 telephone service (available to anyone in BC) categorized as "seek care within 24 hours" by registered nurses were eligible for referral to HEiDi. HEiDi physicians ("virtual physicians") connected directly with callers via desktop videoconferencing software, assessed their health complaint, provided advice and suggested care disposition. We conducted a descriptive study and collected demographic characteristics, health concern and disposition determined by the virtual physician.

RESULTS

HEiDi virtual physicians provided 7687 consultations. Most patients ( = 4439, 57.8%) were in the 20-64 age range, and 4814 (62.9%) were female. Common health concerns were related to gastroenterology ( = 1275, 16.6%), respiratory ( = 877, 11.4%) and dermatology ( = 874, 11.4%). From the 7531 calls with available data, 2548 (33.8%) callers were advised to attempt home treatment, 2885 (38.3%) to contact a primary care physician within 1 week, 1131 (15.0%) to attend an emergency department immediately and 538 (7.1%) to attend their primary provider now.

INTERPRETATION

We found that virtual physicians were able to advise nearly 3 out of 4 (72.1%) patients away from in-person emergency or clinic assessment and 1 in 7 (15.0%) to seek immediate emergency department care. Virtual physicians can provide an effective complement to a provincial health telephone system.

摘要

背景

不列颠哥伦比亚省（British Columbia）与许多司法管辖区一样，设有一个健康信息电话服务（8-1-1），通过注册护士为来电者提供信息，并帮助他们决定是否前往急诊部或初级保健诊所就诊，或在家中自行处理病情。我们介绍了一种新服务，即 HealthLink BC Emergency iDoctor-in-assistance（HEiDi），该服务与注册护士合作，通过视频会议为来电者提供医生咨询服务。

方法

从 2020 年 4 月 6 日至 8 月 2 日，所有拨打 8-1-1 电话服务（不列颠哥伦比亚省任何人都可拨打）的来电者，如果被注册护士归类为“需要在 24 小时内就诊”，则有资格转介到 HEiDi。HEiDi 医生（“虚拟医生”）通过桌面视频会议软件与来电者直接联系，评估他们的健康投诉，提供建议并建议治疗方案。我们进行了一项描述性研究，并收集了虚拟医生确定的人口统计学特征、健康问题和治疗方案。

结果

HEiDi 虚拟医生提供了 7687 次咨询服务。大多数患者（=4439，57.8%）年龄在 20-64 岁之间，4814 名（62.9%）为女性。常见的健康问题与胃肠病学（=1275，16.6%）、呼吸科（=877，11.4%）和皮肤科（=874，11.4%）有关。在 7531 个有数据可查的电话中，有 2548 个（33.8%）来电者被建议尝试家庭治疗，2885 个（38.3%）在 1 周内联系初级保健医生，1131 个（15.0%）立即前往急诊部就诊，538 个（7.1%）立即前往初级保健医生处就诊。