Telepulmonology: Effect on quality and efficiency of care

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• 作者：Leonie Thijssing ; Job P. van der Heijden ; Niels H. Chavannes ; Christian F. Melissant ; Monique W.M. Jaspers ; Leonard Witkamp
• 关键词：Telemedicine ; Pulmonary medicine ; Quality improvement ; Efficiency
• 刊名：Respiratory Medicine
• 出版年：February, 2014
• 年：2014
• 卷：108
• 期：2
• 页码：314-318
• 全文大小：364 K

文摘

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Summary

Background

Interpreting spirometry results has proven challenging in primary care practice, among others potentially leading to under- and misdiagnosis of COPD. In telepulmonology a general practitioner (GP) digitally consults a pulmonologist to support the interpretation of spirometry results. This study assessed the effect of telepulmonology on quality and efficiency of care.

Methods

Quality of care was measured by five indicators, among others the percentage of TelePulmonology Consultations (TPCs) sent by GPs for advice, percentage of those TPCs resulting in a physical referral, and educational effect of telepulmonology as experienced by GPs. Efficiency was defined as the percentage of prevented unnecessary physical referrals of patients to the pulmonologist.

Results

Between April 2009 and November 2012 1.958 TPCs were sent by 158 GPs to 32 pulmonologists. Sixty-nine percent of the TPCs were sent for advice. Based on the advice of the聽pulmonologist 18% of these TPCs led to a physical referral of patients who would not have聽been referred without telepulmonology. Thirty-one percent of the TPCs were intended to prevent a physical referral, 68% of these actually prevented a physical referral to a pulmonologist.

Conclusion

The results show telepulmonology can contribute to quality of care by supporting GPs and can additionally prevent unnecessary physical referrals.