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耳门户:一个基于城市的耳鼻喉科和听力学转诊远程医疗门户,旨在改善儿童获得专科耳部健康服务的机会。

Ear Portal: An urban-based ear, nose, and throat, and audiology referral telehealth portal to improve access to specialist ear health services for children.

机构信息

Medical School, The University of Western Australia, Perth, WA, Australia.

Ear Health, Telethon Kids Institute, The University of Western Australia, Nedlands, WA, Australia.

出版信息

J Telemed Telecare. 2024 Dec;30(10):1581-1589. doi: 10.1177/1357633X231158839. Epub 2023 Mar 14.

Abstract

INTRODUCTION

Shortage of ear, nose, and throat specialists in public hospitals can result in delays in the detection and management of otitis media. This study introduced a new hospital-based telehealth service, named the Ear Portal, and investigated its role in improving access to specialist care.

METHODS

The study included 87 children (aged 6 months to 6 years) referred to a tertiary children's hospital due to otitis media-related concerns. A specialist multidisciplinary team met fortnightly to review pre-recorded data and provide care plans.

RESULTS

The service resulted in a median waiting time of 28 days to receive a diagnosis and care plan by the multidisciplinary team, compared to a mean waiting time of 450 days for a reference group receiving standard healthcare services. Most children (90.3%) received bilateral ear diagnosis. Normal findings were found in 43.9%. However, the majority required further ear, nose, and throat with or without audiology face-to-face follow-up due to a diagnosis of middle-ear disease, unknown hearing status, or concerns not related to ears. The mean time required for clinical assessments completion by research assistants and multidisciplinary team review was 37.6 and 5.1 min per participant, respectively.

DISCUSSION

Children in the Ear Portal service received a diagnosis and care plan in a median of 28 days, which is within the clinically recommended timeframes. With sufficient clinical information, this service can provide faster access to specialist care than the standard healthcare pathway. The service can reduce the time required by the specialist to provide a diagnosis and care plan which may help increase the specialists' capacity.

摘要

简介

公立医院耳鼻喉科专家短缺可能导致中耳炎的检测和管理延迟。本研究引入了一种新的基于医院的远程医疗服务,名为“Ear Portal”,并调查了其在改善专科护理获取方面的作用。

方法

该研究纳入了 87 名(6 个月至 6 岁)因中耳炎相关问题转诊至三级儿童医院的儿童。一个由多学科专家组成的团队每两周开会一次,以回顾预先录制的数据并提供护理计划。

结果

与接受标准医疗保健服务的参照组相比,该服务使接受多学科团队诊断和护理计划的中位等待时间从 450 天缩短至 28 天。大多数儿童(90.3%)接受了双耳诊断。正常发现占 43.9%。然而,由于中耳疾病、未知听力状况或与耳朵无关的问题,大多数儿童需要进一步进行耳鼻喉科检查和/或听力检查。研究助理和多学科团队分别需要 37.6 分钟和 5.1 分钟完成每位参与者的临床评估。

讨论

Ear Portal 服务中的儿童在中位数为 28 天内获得了诊断和护理计划,这在临床推荐的时间范围内。有了足够的临床信息,该服务可以比标准医疗保健途径更快地获得专科护理。该服务可以减少专家提供诊断和护理计划所需的时间,这可能有助于增加专家的能力。

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