Chertack Nathan, Lotan Yair, Mayorga Christian, Mauck Ryan
Department of Urology, UT Southwestern, Dallas, Texas.
Division of Digestive and Liver Diseases, UT Southwestern, Dallas, Texas.
Urol Pract. 2020 Nov;7(6):448-453. doi: 10.1097/UPJ.0000000000000140. Epub 2020 Jan 20.
We assess the implementation of an e-consult service at a urology clinic in a safety net county hospital.
An e-consult system was introduced in 2018 at our institution. All e-consults for January to December 2018 were collected and data analyzed. Patient demographics were recorded. Total consults, clinic referrals, cystoscopy referrals, need to reschedule and need for followup were compared. Time from referral to in-person clinic visit was collected. Reason for e-consult and final visit diagnosis were placed into urological categories and subcategories.
In 2018 472 e-consults were received for 454 patients. The majority were men (62.3%) with a median age of 55 years (IQR 44-63). The majority (52%) were Hispanic. Most patients (69.1%) were scheduled for an in-person clinic visit with 23.9% of these patients scheduled for a cystoscopy. Median time from referral to in-person clinic visit was 39.5 days (IQR 33-50). A quarter of the patients did not require further followup after initial in-person consultation. The majority of e-consults were for hematuria (24%), renal pathologies (20%), and benign prostatic hyperplasia and lower urinary tract symptoms (17%).
Implementation of a urology e-consult service is feasible and decreases need for in-person clinic visits.
我们评估了在安全网县医院的泌尿外科诊所实施电子咨询服务的情况。
2018年我们机构引入了电子咨询系统。收集了2018年1月至12月的所有电子咨询并进行数据分析。记录了患者的人口统计学信息。比较了总咨询量、门诊转诊量、膀胱镜检查转诊量、重新安排时间的需求和随访需求。收集了从转诊到门诊就诊的时间。将电子咨询的原因和最终就诊诊断归入泌尿外科类别和子类别。
2018年共收到472例针对454名患者的电子咨询。大多数为男性（62.3%），中位年龄为55岁（四分位间距44 - 63）。大多数（52%）为西班牙裔。大多数患者（69.1%）安排了门诊就诊，其中23.9%的患者安排了膀胱镜检查。从转诊到门诊就诊的中位时间为39.5天（四分位间距33 - 50）。四分之一的患者在首次门诊咨询后无需进一步随访。大多数电子咨询是关于血尿（24%）、肾脏疾病（20%）以及良性前列腺增生和下尿路症状（17%）。
实施泌尿外科电子咨询服务是可行的，并减少了门诊就诊的需求。
