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内分泌疾病的电子会诊:一项范围综述

Electronic Consultations for Endocrine Conditions: A Scoping Review.

作者信息

Abdellatif Bahaa, Natarajan Varun, Leibowitz Alison J, Sitter Kailyn E, Vimalananda Varsha G

机构信息

Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, Bedford, MA 01730, USA.

Boston University Chobanian and Avedisian School of Medicine, Boston, MA 02118, USA.

出版信息

J Endocr Soc. 2024 Oct 1;8(11):bvae170. doi: 10.1210/jendso/bvae170. eCollection 2024 Sep 26.

Abstract

Electronic consultations (e-consults) are a mode of referral increasingly used to provide access to endocrine specialty care without the need for a patient in-person visit. This scoping review aimed to describe the models being used to deliver endocrine care via e-consult, what is known about outcomes of endocrine e-consult, and research gaps. The review was completed using an established methodological framework. PubMed, Embase, CINAHL, and Cochrane were searched for articles published in English between January 1, 2000, and March 21, 2024, that reported on e-consults for endocrine specialty care. The database search yielded 2522 articles, of which 19 underwent data extraction and synthesis. The overall body of endocrine e-consult literature is small and largely observational. Various models for endocrine e-consult programs exist. Findings on feasibility, acceptability, and timeliness are positive and consistent with the larger body of e-consult literature. Data on outcomes are limited but suggest that e-consults are no worse than other referral approaches to lowering A1C. Improvements in outcomes are greater for patients whose primary care providers implement e-consult recommendations. In summary, existing studies support the benefits of e-consults in various aspects of endocrine care quality, but the literature is nascent and there are significant research gaps. Future research should examine how e-consults can best address specific endocrine conditions, with a broad set of outcomes that addresses multiple quality dimensions. Advanced study designs and qualitative methods can help address unresolved questions about e-consults relevant to all specialties, including impact on care coordination and costs and best practices for reimbursement and workflow.

摘要

电子会诊(e-consults)是一种越来越常用的转诊方式,无需患者亲自就诊即可获得内分泌专科护理。本范围综述旨在描述通过电子会诊提供内分泌护理所采用的模式、关于内分泌电子会诊结果的已知情况以及研究空白。该综述使用既定的方法框架完成。在PubMed、Embase、CINAHL和Cochrane数据库中检索了2000年1月1日至2024年3月21日期间以英文发表的、报道内分泌专科护理电子会诊的文章。数据库搜索共得到2522篇文章,其中19篇进行了数据提取和综合分析。内分泌电子会诊文献的总体数量较少,且大多为观察性研究。存在多种内分泌电子会诊项目模式。关于可行性、可接受性和及时性的研究结果是积极的,与大量电子会诊文献一致。关于结果的数据有限,但表明电子会诊在降低糖化血红蛋白(A1C)方面并不比其他转诊方法差。对于其初级保健提供者实施电子会诊建议的患者,结果改善更大。总之,现有研究支持电子会诊在内分泌护理质量的各个方面都有好处,但该文献尚处于初期阶段,存在重大研究空白。未来的研究应探讨电子会诊如何最好地应对特定的内分泌疾病,同时要有一套广泛的结果指标,涵盖多个质量维度。先进的研究设计和定性方法有助于解决与所有专科相关的、关于电子会诊的未解决问题,包括对护理协调和成本的影响以及报销和工作流程的最佳实践。

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