Primary Health Physician, Aragon Health Service, Zaragoza, Spain
Health Services Research Group (GRISSA), Aragon Health Research Institute, Zaragoza, Spain.
BMJ Open Qual. 2023 Oct;12(4). doi: 10.1136/bmjoq-2023-002388.
Virtual consultation has been proposed as a promising tool to improve the coordination and quality of healthcare between primary and specialised care. However, despite its potential facilitators, the evidence on the usefulness of virtual consultation for improving healthcare quality domains is fragmented and unclear. This scoping review aims to assess the impact of virtual consultation on different healthcare quality domains.
We conducted a scoping review with a rigorous search strategy on PubMed, EMBASE and Cochrane Library databases. The inclusion criteria were original articles, reviews, meta-analyses or letters to the editor, published between 1 January 2017 and 24 June 2022, and available in English, Spanish or French. For each of the articles selected, we identified the addressed healthcare quality domains, their facilitators and barriers, areas of improvement and data gaps. We have adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Review reporting standards.
1284 manuscripts were retrieved. Finally, 235 papers were included in this review, most of which were original, descriptive studies. The most evaluated quality domain was effectiveness (223 articles). Safety and patient-centred care were the least evaluated. Simultaneous assessment of more than one domain was observed in 117 papers, being effectiveness and timeliness the most frequent combination. Our analysis revealed that virtual consultation is in development and underused. This tool has the potential to improve access to specialised care and enhance coordination between professionals.
Virtual consultation has the potential to provide effective, efficient, equitable and timely attention. However, its contribution to safety and patient-centered care needs further evaluation. Our review emphasises the need for more rigorous research and standardised quality assessment criteria to obtain robust evidence on the usefulness of virtual consultation for improving healthcare quality domains.
虚拟咨询被提出作为一种有前途的工具,可以改善初级保健和专科保健之间的协调和医疗质量。然而,尽管有其潜在的促进因素,但关于虚拟咨询在改善医疗质量领域的有用性的证据是分散和不清楚的。本范围综述旨在评估虚拟咨询对不同医疗质量领域的影响。
我们进行了一项范围综述,采用严格的搜索策略在 PubMed、EMBASE 和 Cochrane Library 数据库中进行。纳入标准是发表于 2017 年 1 月 1 日至 2022 年 6 月 24 日之间的原创文章、综述、荟萃分析或给编辑的信,且为英文、西班牙语或法语。对于每一篇选定的文章,我们确定了所涉及的医疗质量领域、它们的促进因素和障碍、改进领域和数据差距。我们遵循了系统评价和荟萃分析的首选报告项目用于范围综述报告标准。
共检索到 1284 篇手稿。最后,共有 235 篇论文被纳入本综述,其中大多数为原创、描述性研究。评价最多的质量领域是有效性(223 篇文章)。安全性和以患者为中心的护理评价最少。在 117 篇论文中观察到同时评估多个领域,最常见的组合是有效性和及时性。我们的分析表明,虚拟咨询正在发展和未充分利用。该工具有可能改善获得专科护理的机会,并加强专业人员之间的协调。
虚拟咨询有可能提供有效、高效、公平和及时的关注。然而,它对安全性和以患者为中心的护理的贡献需要进一步评估。我们的综述强调需要进行更严格的研究和标准化的质量评估标准,以获得关于虚拟咨询在改善医疗质量领域的有用性的可靠证据。