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通过在新斯科舍省实施虚拟走廊(一个咨询平台)改善医疗服务的可及性和质量:可行性评估的初步结果

Improved access and care through the implementation of virtual Hallway, a consultation platform in Nova Scotia: preliminary findings from a feasibility evaluation.

作者信息

Tomblin Murphy Gail, Sampalli Tara, Koto Prosper, Chamberland-Rowe Caroline, Guk Julia, Ventura Nelson, Hartlen Justin, Rasic Daniel, Allen Jonathan, Benson Kianna, MacNeil Ryan

机构信息

Nova Scotia Health, 90 Lovett Lake Crt, Suite 201, B3S 0H6, Halifax, NS, Canada.

Virtual Hallway, 5663 Nora Bernard St. Suite 200, B3K 1B6, Halifax, NS, Canada.

出版信息

Implement Sci Commun. 2024 Oct 18;5(1):116. doi: 10.1186/s43058-024-00651-3.

Abstract

BACKGROUND

While previous studies have examined various platforms that enable providers to connect, Virtual Hallway (VH) stands out with its unique features. The value add is that this online platform connects primary care providers and specialists for synchronous phone-based conversations and aims to reduce referrals and enhance the quality of referrals. VH allows providers to easily log in, select the required specialty, book call times, receive reminders, and have calls documented, ensuring a high connection rate. In May 2022, the provincial health authority in Nova Scotia, a Canadian province, and VH initiated a feasibility study facilitated through the Health Innovation Hub in Nova Scotia. The goal was to enable primary care providers to connect with specialists, thereby reducing wait times and unnecessary referrals, and facilitating timely access to relevant clinical direction for patients. The current evaluation assessed utilization, value for money in economic analysis, and consultation experiences.

METHODS

The study used post, cross-sectional, and cost-benefit study designs. We collected data through various methods, including administratively recorded utilization, theory-driven surveys, and cost data. Utilization was measured by the number of completed consults and the number of healthcare professionals using the VH platform. We analyzed the data using a combination of descriptive statistics and a cost-benefit analysis, which also involved conducting probabilistic sensitivity analysis.

RESULTS

The study found that approximately 84% of the VH consultations avoided needing in-person specialist referrals. The return on investment was 1.8 (95% CI: 0.8 to 3.0), indicating that the monetary value of the measurable benefits associated with VH exceeded the value of the resources invested. The provider experience survey revealed high satisfaction levels with VH across user groups, with 92% of specialists and 96% of primary care providers reporting being satisfied or highly satisfied with their experience. These positive indicators of provider experience were further supported by the fact that 97% of respondents agreed or strongly agreed that they intended to continue to use VH in their practice, and 97% of respondents agreed or strongly agreed that they would recommend VH to a colleague.

CONCLUSIONS

The study suggests that VH was well-received by users, with high levels of satisfaction reported and a reduced need for in-person referrals. It also represented value for money. Further research could explore how the availability of virtual health services can lead to reduced utilization of healthcare resources among different groups of patients.

摘要

背景

虽然先前的研究考察了各种能让医疗服务提供者建立联系的平台,但虚拟走廊(VH)凭借其独特功能脱颖而出。其附加值在于,这个在线平台连接了初级保健提供者和专科医生,以便进行基于电话的同步对话,旨在减少转诊并提高转诊质量。VH让医疗服务提供者能够轻松登录,选择所需专科,预订通话时间,接收提醒,并记录通话内容,确保了高接通率。2022年5月,加拿大新斯科舍省的省级卫生当局与VH发起了一项通过新斯科舍省卫生创新中心推动的可行性研究。目标是让初级保健提供者能够与专科医生建立联系,从而减少等待时间和不必要的转诊,并为患者及时提供相关临床指导。当前的评估考察了利用率、经济分析中的性价比以及咨询体验。

方法

该研究采用了事后、横断面和成本效益研究设计。我们通过多种方法收集数据,包括行政记录的利用率、理论驱动的调查和成本数据。利用率通过完成的咨询次数和使用VH平台的医疗专业人员数量来衡量。我们结合描述性统计和成本效益分析对数据进行了分析,其中还包括进行概率敏感性分析。

结果

研究发现,约84%的VH咨询避免了进行面对面的专科转诊。投资回报率为1.8(95%置信区间:0.8至3.0),这表明与VH相关的可衡量效益的货币价值超过了所投入资源的价值。提供者体验调查显示,各用户群体对VH的满意度都很高,92%的专科医生和96%的初级保健提供者表示对其体验满意或非常满意。97%的受访者同意或强烈同意他们打算在实践中继续使用VH,97%的受访者同意或强烈同意他们会向同事推荐VH,这一事实进一步支持了提供者体验的这些积极指标。

结论

该研究表明,VH受到了用户的好评,满意度很高,且面对面转诊需求减少。它还体现了性价比。进一步的研究可以探索虚拟健康服务的可及性如何导致不同患者群体对医疗资源的利用率降低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/57af/11488209/46dfa490e67e/43058_2024_651_Fig1_HTML.jpg

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