Asynchronous vascular consultation via electronic methods: A feasibility pilot.
Identifieur interne : 002109 ( Main/Exploration ); précédent : 002108; suivant : 002110Asynchronous vascular consultation via electronic methods: A feasibility pilot.
Auteurs : Melissa D. Chittle [États-Unis] ; Sandhya K. Rao [États-Unis] ; Michael R. Jaff [États-Unis] ; Virendra I. Patel [États-Unis] ; Kathleen M. Gallen [États-Unis] ; Radhika Avadhani [États-Unis] ; Timothy G. Ferris [États-Unis] ; Jason H. Wasfy [États-Unis]Source :
- Vascular medicine (London, England) [ 1477-0377 ] ; 2015.
Descripteurs français
- KwdFr :
- Accountable care organizations (USA), Attitude du personnel soignant, Centres de soins tertiaires, Centres hospitaliers universitaires, Consultation médicale, Consultation à distance (), Diagnostic par imagerie (), Dossiers médicaux, Enquêtes et questionnaires, Humains, Maladie chronique, Maladies vasculaires (), Maladies vasculaires (diagnostic), Médecins de premier recours (psychologie), Orientation vers un spécialiste, Prestations des soins de santé (), Projets pilotes, Pronostic, Satisfaction du patient, Types de pratiques des médecins, Valeur prédictive des tests, Épreuve d'effort, Études de faisabilité, Évaluation de programme.
- MESH :
- diagnostic : Maladies vasculaires.
- psychologie : Médecins de premier recours.
- Accountable care organizations (USA), Attitude du personnel soignant, Centres de soins tertiaires, Centres hospitaliers universitaires, Consultation médicale, Consultation à distance, Diagnostic par imagerie, Dossiers médicaux, Enquêtes et questionnaires, Humains, Maladie chronique, Maladies vasculaires, Orientation vers un spécialiste, Prestations des soins de santé, Projets pilotes, Pronostic, Satisfaction du patient, Types de pratiques des médecins, Valeur prédictive des tests, Épreuve d'effort, Études de faisabilité, Évaluation de programme.
English descriptors
- KwdEn :
- Academic Medical Centers, Accountable Care Organizations, Attitude of Health Personnel, Chronic Disease, Delivery of Health Care (methods), Diagnostic Imaging (methods), Exercise Test, Feasibility Studies, Humans, Medical Records, Office Visits, Patient Satisfaction, Physicians, Primary Care (psychology), Pilot Projects, Practice Patterns, Physicians', Predictive Value of Tests, Prognosis, Program Evaluation, Referral and Consultation, Remote Consultation (methods), Surveys and Questionnaires, Tertiary Care Centers, Vascular Diseases (diagnosis), Vascular Diseases (therapy).
- MESH :
- diagnosis : Vascular Diseases.
- methods : Delivery of Health Care, Diagnostic Imaging, Remote Consultation.
- psychology : Physicians, Primary Care.
- therapy : Vascular Diseases.
- Academic Medical Centers, Accountable Care Organizations, Attitude of Health Personnel, Chronic Disease, Exercise Test, Feasibility Studies, Humans, Medical Records, Office Visits, Patient Satisfaction, Pilot Projects, Practice Patterns, Physicians', Predictive Value of Tests, Prognosis, Program Evaluation, Referral and Consultation, Surveys and Questionnaires, Tertiary Care Centers.
Abstract
Management of chronic disease often requires multidisciplinary clinical efforts and specialist care. With the emergence of Accountable Care Organizations (ACOs), health care systems are incentivized to evaluate methods of information exchange between generalists and specialists in order to provide value while preserving quality. Our objective was to evaluate patient and referring provider satisfaction and outcomes of asynchronous electronic consultations in vascular care in a large tertiary academic medical center. Referring providers were offered a vascular 'e-consult' option through an electronic referral management system. We conducted chart review to understand the downstream effects and surveyed patients and referring providers to assess satisfaction. From 24 March 2014 to 1 March 2015, 54 e-consults were completed. Additional testing and recommendations were made in 49/54 (90.7%) e-consults, including lower-extremity venous duplex ultrasonography with reflux testing, duplex ultrasonography of the carotid artery, computed tomography, magnetic resonance imaging, non-invasive physiology arterial studies, laboratory tests, medications, compression stockings, and sequential lymphedema compression therapy. Referring providers were compliant with recommendations in 40/49 (81.6%) of e-consults. A total of 17/54 (31.5%) patients were surveyed with a median patient satisfaction score of 13.7/15 (91.3%) (SD ± 6.4). The program was associated with high referring provider satisfaction, with 87.0% finding the e-consult very helpful and 80.0% stating it averted the need for a traditional visit. Our experience suggests that e-consults are an effective way to provide vascular care in some patients and are associated with high patient and provider satisfaction. E-consults may therefore be an efficient method of care delivery for vascular patients within an ACO.
DOI: 10.1177/1358863X15601734
PubMed: 26385414
Affiliations:
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Le document en format XML
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xml:lang="en"><term>Academic Medical Centers</term><term>Accountable Care Organizations</term><term>Attitude of Health Personnel</term><term>Chronic Disease</term><term>Delivery of Health Care (methods)</term><term>Diagnostic Imaging (methods)</term><term>Exercise Test</term><term>Feasibility Studies</term><term>Humans</term><term>Medical Records</term><term>Office Visits</term><term>Patient Satisfaction</term><term>Physicians, Primary Care (psychology)</term><term>Pilot Projects</term><term>Practice Patterns, Physicians'</term><term>Predictive Value of Tests</term><term>Prognosis</term><term>Program Evaluation</term><term>Referral and Consultation</term><term>Remote Consultation (methods)</term><term>Surveys and Questionnaires</term><term>Tertiary Care Centers</term><term>Vascular Diseases (diagnosis)</term><term>Vascular Diseases (therapy)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Accountable care organizations (USA)</term><term>Attitude du personnel 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de programme</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Management of chronic disease often requires multidisciplinary clinical efforts and specialist care. With the emergence of Accountable Care Organizations (ACOs), health care systems are incentivized to evaluate methods of information exchange between generalists and specialists in order to provide value while preserving quality. Our objective was to evaluate patient and referring provider satisfaction and outcomes of asynchronous electronic consultations in vascular care in a large tertiary academic medical center. Referring providers were offered a vascular 'e-consult' option through an electronic referral management system. We conducted chart review to understand the downstream effects and surveyed patients and referring providers to assess satisfaction. From 24 March 2014 to 1 March 2015, 54 e-consults were completed. Additional testing and recommendations were made in 49/54 (90.7%) e-consults, including lower-extremity venous duplex ultrasonography with reflux testing, duplex ultrasonography of the carotid artery, computed tomography, magnetic resonance imaging, non-invasive physiology arterial studies, laboratory tests, medications, compression stockings, and sequential lymphedema compression therapy. Referring providers were compliant with recommendations in 40/49 (81.6%) of e-consults. A total of 17/54 (31.5%) patients were surveyed with a median patient satisfaction score of 13.7/15 (91.3%) (SD ± 6.4). The program was associated with high referring provider satisfaction, with 87.0% finding the e-consult very helpful and 80.0% stating it averted the need for a traditional visit. Our experience suggests that e-consults are an effective way to provide vascular care in some patients and are associated with high patient and provider satisfaction. E-consults may therefore be an efficient method of care delivery for vascular patients within an ACO.</div></front></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Massachusetts</li></region></list><tree><country name="États-Unis"><region name="Massachusetts"><name sortKey="Chittle, Melissa D" sort="Chittle, Melissa D" uniqKey="Chittle M" first="Melissa D" last="Chittle">Melissa D. Chittle</name></region><name sortKey="Avadhani, Radhika" sort="Avadhani, Radhika" uniqKey="Avadhani R" first="Radhika" last="Avadhani">Radhika Avadhani</name><name sortKey="Ferris, Timothy G" sort="Ferris, Timothy G" uniqKey="Ferris T" first="Timothy G" last="Ferris">Timothy G. Ferris</name><name sortKey="Gallen, Kathleen M" sort="Gallen, Kathleen M" uniqKey="Gallen K" first="Kathleen M" last="Gallen">Kathleen M. Gallen</name><name sortKey="Jaff, Michael R" sort="Jaff, Michael R" uniqKey="Jaff M" first="Michael R" last="Jaff">Michael R. Jaff</name><name sortKey="Patel, Virendra I" sort="Patel, Virendra I" uniqKey="Patel V" first="Virendra I" last="Patel">Virendra I. Patel</name><name sortKey="Rao, Sandhya K" sort="Rao, Sandhya K" uniqKey="Rao S" first="Sandhya K" last="Rao">Sandhya K. Rao</name><name sortKey="Wasfy, Jason H" sort="Wasfy, Jason H" uniqKey="Wasfy J" first="Jason H" last="Wasfy">Jason H. Wasfy</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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