Hertens Sarah, Van der Mullen Chris, Schoenmakers Birgitte
Department of General Practice and Chronic Care, VUB, Laarbeeklaan 103, Brussel (Jette), 1090, Belgium.
Department of Public Health and Primary Care, KU Leuven, KU Leuven, Kapucijnenvoer 7, box 7001, Leuven, 3000, Belgium.
Arch Public Health. 2023 Mar 24;81(1):43. doi: 10.1186/s13690-023-01058-7.
Since 2000, an increasing misuse of emergency services in Belgium was noticed. In 2015, a multidisciplinary task-force designed a triage system. Trained operators and integrated triage protocols were installed in a call center for life-threatening and non-life-threatening care needs. Teleconsultations by telephone find their way to planned care and are well studied in this context. Also unplanned care might benefit from telephone-consultations.
This intervention study investigated the feasibility of teleconsultations in unplanned care according to medical doctors. They were present at the call center during the weekend and on public holidays in the period of April 17, 2021 to November 21, 2021. Their task was to call patients who had contacted the call center to perform a teleconsultation, without interfering with regular care.
21 triage doctors participated in the study, they completed 59 surveys and conducted 551 teleconsultations. They perceived the quality of the consultations as good with an average score of 82.85 out of 100 on the sliding scale. The doctors gave an average score of 72.40 for the level of certainty for diagnosis and treatment. For 415 consultations, triage doctors judged that the consultation would gain certainty if followed by a physical examination. Video was mainly considered to be valuable in psychiatric problems, allergic reactions and skin problems.
This study showed that teleconsultations are feasible in unplanned care. Videos add value in particular cases. Only few barriers are reported in terms of communication, technology and equipment.
Teleconsultations in unplanned primary care could be performed with a high quality and a sufficient level of certainty. The willingness to conduct teleconsultations in unplanned care is high. It would be useful in a future study to investigate the feasibility, obstacles and needs for implementation of video consultations as they may differ from teleconsultations.
自2000年以来,比利时紧急服务的滥用现象日益严重。2015年,一个多学科特别工作组设计了一种分诊系统。训练有素的操作人员和综合分诊协议被安装在一个呼叫中心,用于处理危及生命和非危及生命的护理需求。电话远程会诊已应用于计划性护理,并且在这方面已有充分研究。非计划性护理也可能从电话会诊中受益。
这项干预性研究调查了根据医生意见进行的非计划性护理中电话会诊的可行性。在2021年4月17日至2021年11月21日的周末和公共假日期间,他们在呼叫中心值班。他们的任务是给联系过呼叫中心的患者打电话进行远程会诊,且不干扰常规护理。
21名分诊医生参与了该研究,他们完成了59份调查问卷并进行了551次远程会诊。他们认为会诊质量良好,在滑动量表上的平均得分为82.85(满分100分)。医生对诊断和治疗的确定性水平平均评分为72.40分。对于415次会诊,分诊医生判断如果随后进行体格检查,会诊的确定性将会提高。视频主要被认为在精神问题、过敏反应和皮肤问题中具有价值。
这项研究表明,远程会诊在非计划性护理中是可行的。视频在特定情况下具有附加价值。在沟通、技术和设备方面报告的障碍很少。
非计划性初级护理中的远程会诊可以高质量且具有足够的确定性水平进行。在非计划性护理中进行远程会诊的意愿很高。在未来的研究中,调查视频会诊实施的可行性、障碍和需求可能会很有用,因为它们可能与远程会诊有所不同。