Embedding telemedicine quality assurance within a large organisation

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• 作者：R. Wootton^a ; ^b ; ^{r_wootton@pobox.com" class="auth_mail" title="E-mail the corresponding author} ; J. Liu^c ; L. Bonnardot^d ; ^e
• 关键词：Teleconsulting ; Low-resource setting ; Quality assurance ; Quality improvement
• 刊名：European Research in Telemedicine / La Recherche Européenne en Télémédecine
• 出版年：2016
• 出版时间：June 2016
• 年：2016
• 卷：5
• 期：2
• 页码：55-63
• 全文大小：951 K

文摘

Quality assurance (QA) is common in certain areas of medicine, such as laboratory work, but there has been little QA in telemedicine so far. We reviewed the QA activities in a store-and-forward telemedicine network, which provides about 1000 teleconsultations per annum in low-resource settings. This work was compared with comprehensive QA programmes in other health care systems to identify areas for future consolidation.

Patients and methods

The QA activities conducted in the telemedicine network were reviewed over a 30-month period. Comparison was made with a framework for QA designed to support lower- and middle-income countries.

Results

During the study period, a total of 2068 telemedicine cases were submitted by 154 field users. A number of problems were detected by regular QA monitoring and various adverse events were identified. The QA work was feasible and useful, enabling early detection of problems and the speedy resolution of some of them; other issues required authority above the level of the people working in the telemedicine programme.

Discussion

The review demonstrated the feasibility and value of a QA programme in a store-and-forward telemedicine operation. However, this represents QA at a fairly low, process level.

Conclusions

Comparison with other healthcare organisations showed that consolidation of the QA activities into a comprehensive QA programme would be required in order to achieve institutionalization of the work, and to realise its full potential. While this might incur costs in the short-term, the increased efficiency and effectiveness could lead to net savings for the organisation in the long-term.