Harada Taku, Morikawa Toru, Furuya Hiroki, Sato Tomoki, Kakehi Minami, Yamada Hiroki, Shimizu Taro
Department of General Medicine, Nerima Hikarigaoka Hospital, Nerima, JPN.
Department of Diagnostic and Generalist Medicine, Dokkyo Medical University Hospital, Mibu, JPN.
Cureus. 2024 Dec 31;16(12):e76690. doi: 10.7759/cureus.76690. eCollection 2024 Dec.
Introduction Electronic consultations (e-consults) refer to digital health technologies that enhance clinical information sharing and improve patients' access to expert healthcare providers. This study aims to describe the current utilization of the Internet/application-based e-consult system and to assess how effectively it resolves clinical questions. Methods Participants were general practitioners (GPs) who had installed the e-consult platform on their personal computers or cell phones. Hospital specialists who responded to the e-consults were previously registered on our e-consult platform and also participated in the study. We have developed and implemented an Internet/application-based e-consult system that GPs can use on their personal computers in Japan. In this descriptive study, GPs used the e-consult platform via an Internet/application to consult hospital specialists. The study period was from May 1, 2020, to October 31, 2021. The outcome measure was the resolution rate, calculated by dividing the number of cases resolved solely through e-consults by the total number of e-consult cases. Another outcome measure was the number of cases in which a plan was determined using e-consults. Other outcome measures were GP satisfaction, assessed using a 5-point Likert scale for e-consults, the number of chats required for a hospital specialist to respond, and the time from the GP's initial question to the hospital specialist's first response. Results Of the 329 e-consult cases identified, 91 conducted by GPs were included in the final analysis. The number of cases resolved using only e-consults was 47, resulting in a resolution rate of 52% in the study. The minor specialists exhibited the highest resolution rate using e-consults alone. The number of cases where a plan was determined using e-consults was 83, accounting for 91% of the total 91 cases. The level of GP satisfaction with the e-consult process was high, with a median satisfaction score of 5 on a 5-point Likert scale. Most e-consults received their initial response within two hours. The number of chats required for hospital specialists to respond was very low, with a median of only one chat being necessary. Conclusion The Internet/application-based e-consult system enabled GPs to address a wide range of medical problems. Further studies with large samples are necessary, even though these results serve as an important benchmark for future research on e-consults in Japan.
引言 电子会诊（e-consults）是指利用数字健康技术来加强临床信息共享，并改善患者获得专家医疗服务的途径。本研究旨在描述基于互联网/应用程序的电子会诊系统的当前使用情况，并评估其解决临床问题的有效性。方法 参与者为在个人电脑或手机上安装了电子会诊平台的全科医生（GPs）。回复电子会诊的医院专科医生此前已在我们的电子会诊平台上注册，并参与了本研究。我们开发并实施了一种基于互联网/应用程序的电子会诊系统，日本的全科医生可在其个人电脑上使用该系统。在这项描述性研究中，全科医生通过互联网/应用程序使用电子会诊平台向医院专科医生咨询。研究期间为2020年5月1日至2021年10月31日。结果指标为解决率，通过仅通过电子会诊解决的病例数除以电子会诊病例总数来计算。另一个结果指标是通过电子会诊确定治疗方案的病例数。其他结果指标包括全科医生的满意度（使用5级李克特量表对电子会诊进行评估）、医院专科医生回复所需的聊天次数，以及从全科医生最初提问到医院专科医生首次回复的时间。结果 在确定的329例电子会诊病例中，最终分析纳入了全科医生进行的91例。仅通过电子会诊解决的病例数为47例，本研究中的解决率为52%。仅使用电子会诊时，专科医生的解决率最高。通过电子会诊确定治疗方案的病例数为83例，占91例总数的91%。全科医生对电子会诊过程的满意度较高，在5级李克特量表上的满意度中位数为5分。大多数电子会诊在两小时内收到了首次回复。医院专科医生回复所需的聊天次数非常少，中位数仅需一次聊天。结论 基于互联网/应用程序的电子会诊系统使全科医生能够解决广泛的医疗问题。尽管这些结果是日本未来电子会诊研究的重要基准，但仍需要进行更大样本量的进一步研究。
