C.T. Lamont Primary Health Care Research Centre, Bruyere Research Institute, Ottawa, Ontario, Canada.
Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada.
BMJ Open. 2022 Aug 3;12(8):e055049. doi: 10.1136/bmjopen-2021-055049.
To provide an overview of the use of and evidence for eConsult in correctional facilities worldwide.
Scoping review.
Three academic databases (MEDLINE, Embase and CINAHL) were searched to identify papers published between 1990 and 2020 that presented data on eConsult use in correctional facilities. The grey literature was also searched for any resources that discussed eConsult use in correctional facilities. Articles and resources were excluded if they discussed synchronous, patient-to-provider or unsecure communication. The reference lists of included articles were also hand searched.
Of the 226 records retrieved from the academic literature search and 595 from the grey literature search, 22 were included in the review. Most study populations included adult male offenders in a variety of correctional environments. These resources identified 13 unique eConsult services in six countries. Six of these services involved multiple medical specialties, while the remaining services were single specialty. The available evidence was organised into five identified themes: feasibility, cost-effectiveness, access to care, provider satisfaction and clinical impact.
This study identified evidence that the use of eConsult in correctional facilities is beneficial and avoids unnecessary transportation of offenders outside of the facilities. It is feasible, cost-effective, increases access to care, has an impact on clinical care and has high provider satisfaction. Some gaps in the literature remain, and we suggest further research on patient satisfaction, enablers and barriers to implementation, and women, youth and transgender populations in this setting to inform service providers and stakeholders. Despite some gaps, eConsult is evidently an important tool to provide timely, high-quality care to offenders.
概述全球惩教设施中电子咨询的使用情况和证据。
范围综述。
在 1990 年至 2020 年期间，通过三个学术数据库（MEDLINE、Embase 和 CINAHL）搜索了发表的数据，以确定介绍惩教设施中电子咨询使用情况的论文。还搜索了灰色文献，以获取任何讨论惩教设施中电子咨询使用情况的资源。如果文章讨论同步、患者与提供者或不安全的通信，则将其排除在外。还对手头的文章参考文献进行了搜索。
从学术文献检索中检索到 226 条记录，从灰色文献检索中检索到 595 条记录，其中 22 条被纳入综述。大多数研究人群包括各种惩教环境中的成年男性罪犯。这些资源在六个国家确定了 13 种独特的电子咨询服务。其中 6 项服务涉及多个医疗专业，而其余服务则是单一专业。现有的证据被组织成五个已确定的主题：可行性、成本效益、获得护理、提供者满意度和临床影响。
本研究确定了在惩教设施中使用电子咨询是有益的，并避免了不必要的罪犯在设施外的转移。它是可行的、具有成本效益的、增加了获得护理的机会、对临床护理有影响，并且提供者满意度高。文献中仍存在一些空白，我们建议在该环境中进一步研究患者满意度、实施的促成因素和障碍以及妇女、青年和跨性别群体，以为服务提供者和利益相关者提供信息。尽管存在一些空白，但电子咨询显然是为罪犯提供及时、高质量护理的重要工具。
