Content, Utilization and Impact of a Hematology e-Consultation Service
Notice bibliographique
Résumé
Abstract Background Limited access to specialist care remains a major barrier to health care in Canada. The Champlain BASE (Building Access to Specialists through eConsultation) eConsult service is a secure web-based tool that gives primary care providers (PCPs) expedited access to specialist advice for their patients in Ontario, Canada. Hematology is the third most commonly consulted specialty in the eConsult service, accounting for 8% of all cases. The purpose of this study is to perform an in-depth analysis to describe the types of questions, content, utilization, and impact of hematology eConsults submitted by PCPs. Additionally, the results will inform future continuing medical education activities for PCPs. Methods All Hematology eConsults completed between April 1, 2011 and January 31, 2015 were included. We analyzed and categorized each consultation by: (1) clinical content (up to two per case) using a modification of the International Classification for Primary Care (ICPC-2); and (2) type of questions asked by the PCP based on a validated taxonomy. Other data including PCP designation, time for specialist to complete the eConsult, specialist response time, perceived value of the eConsult by the PCP, and the need for a face-to-face referral following the eConsult was collected in real time via the eConsult service and a survey completed by the initiating PCP at the closure of each eConsult. Results There were a total of 436 Hematology eConsults submitted, 87% from physicians and 13% from Nurse Practitioners. Most cases were answered within 3 days. The most common types of questions being asked pertained to management of hematologic disorders (25%), interpretation of a laboratory test (22%) and appropriate further investigative tests (18%). Common clinical content categories were anemia (22%), neutropenia (13%), high ferritin (11%), monoclonal gammopathy of undetermined significance or an abnormal protein electrophoresis (10%) and thrombocytopenia (10%). Two clinical content categories were included in 19% of cases. Self-reported response time by hematologists was under 10 minutes in >75% of cases. Over 66% of cases did not require a face-to-face visit with the specialist following an eConsult; in fact, in 46% of cases an unnecessary referral was avoided. In 4% of cases, a face-to-face consultation was initiated where one was not originally contemplated. PCPs gained new or additional advice for a course of action in 58% of eConsults, and were able to confirm their original course of action in 39% of cases. PCPs rated the value of the eConsult service as ≥4/5 for both themselves and patients in >90% of cases. Impact The hematology eConsult service has significantly increased access to specialist care in a timely manner compared to traditional face-to-face consultations. The service allowed a significant proportion of patients to avoid traditional consultations leading to the potential of cost savings and increased patient safety. Identifying the most common questions and content being asked via the eConsult service will allow for more informed continuing medical education programs for PCPs so that patients can be better served in the primary care setting. Disclosures Khamisa: Amgen: Speakers Bureau.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».