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电子转诊系统SIPILINK在实际生活中的实施与评估。

Real-life implementation and evaluation of the e-referral system SIPILINK.

作者信息

Nun Aimé, Tropeano Anne-Isabelle, Flamarion Edouard, Roumy Arnaud, Azais Henri, Dehghani Kelishadi Léa, Auclin Edouard, Burgun Anita, Katsahian Sandrine, Ranque Brigitte, Metzger Marie-Hélène, Tsopra Rosy

机构信息

Université Paris Cité, Sorbonne Université, Inserm, Centre de Recherche des Cordeliers, F-75006 Paris, France; Inria, HeKA, PariSanté Campus Paris, France; Department of Medical Informatics, AP-HP, Hôpital Européen Georges-Pompidou, Hôpital Necker F-75015 Paris, France; AP-HP, Hôpital Européen Georges-Pompidou, Hôpital Necker F-75015 Paris, France.

Department of Medical Informatics, AP-HP, Hôpital Européen Georges-Pompidou, Hôpital Necker F-75015 Paris, France; AP-HP, Hôpital Européen Georges-Pompidou, Hôpital Necker F-75015 Paris, France.

出版信息

Int J Med Inform. 2025 Feb;194:105605. doi: 10.1016/j.ijmedinf.2024.105605. Epub 2024 Sep 4.

Abstract

INTRODUCTION

General Practitioners (GPs) play a key role of gatekeeper, as they coordinate patients' care. However, most of them reported having difficulty to refer patients to hospital, especially in semi-urgent context. To facilitate the referral of semi-urgent patients, we implemented an e-referral platform, named SIPILINK, within 4 wards from a large public French hospital (internal medicine, diabetology, gynaecological surgery and oncology wards). Here, we aimed to evaluate the SIPILINK e-referral platform after 2 years of implementation.

METHODS

The evaluation included a multidimensional assessment based on the RE-AIM framework with the analysis of implementation, requests, health professionals' satisfaction, and estimated hospital payment.

RESULTS

Over 2 years of implementation, GPs sent 113 requests to hospital. Hospital respected the time of response requested by GPs in 93 % of cases and proposed a consultation or hospitalization in respectively 40.7 % and 10.6 % of cases. 100 % of GPs and 78 % of Hospital Practitioners (HPs) were satisfied with the quality of exchanges. 77 % of HPs and 100 % of Care Pathway Managers (CPMs) found that patient care pathways were improved. Nearly all practitioners would recommend this platform for patient referrals.

DISCUSSION

SIPILINK shows promise in streamlining the referral process, enhancing communication, and improving patient care pathways. Further studies including the impact on the quality of care, are needed to assess its effectiveness and sustainability in healthcare settings.

摘要

引言

全科医生(GPs)作为患者护理协调者,发挥着关键的把关作用。然而,他们中的大多数人表示在将患者转诊至医院时存在困难,尤其是在半紧急情况下。为了促进半紧急患者的转诊,我们在一家大型法国公立医院的4个病房(内科、糖尿病科、妇科外科和肿瘤科病房)实施了一个名为SIPILINK的电子转诊平台。在此,我们旨在评估实施2年后的SIPILINK电子转诊平台。

方法

评估包括基于RE-AIM框架的多维度评估,分析实施情况、转诊请求、医护人员满意度以及估计的医院费用。

结果

在2年的实施过程中,全科医生向医院发送了113份转诊请求。医院在93%的情况下遵守了全科医生要求的响应时间,并分别在40.7%和10.6%的情况下建议进行会诊或住院治疗。100%的全科医生和78%的医院从业者(HPs)对交流质量感到满意。77%的医院从业者和100%的护理路径管理者(CPMs)发现患者护理路径得到了改善。几乎所有从业者都推荐使用这个平台进行患者转诊。

讨论

SIPILINK在简化转诊流程、加强沟通和改善患者护理路径方面显示出前景。需要进一步开展包括对护理质量影响的研究,以评估其在医疗环境中的有效性和可持续性。

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