Artykuły w czasopismach: „Consultations”

1

Atherton, Helen, Anne-Marie Boylan, Abi Eccles, Joanna Fleming, Clare R. Goyder i Rebecca L. Morris. "Email Consultations Between Patients and Doctors in Primary Care: Content Analysis". Journal of Medical Internet Research 22, nr 11 (9.11.2020): e18218. http://dx.doi.org/10.2196/18218.

Pełny tekst źródła

Streszczenie:

Background Increasingly, consultations in health care settings are conducted remotely using a range of communication technologies. Email allows for 2-way text-based communication, occurring asynchronously. Studies have explored the content and nature of email consultations to understand the use, structure, and function of email consultations. Most previous content analyses of email consultations in primary care settings have been conducted in North America, and these have shown that concerns and assumptions about how email consultations work have not been realized. There has not been a UK-based content analysis of email consultations. Objective This study aims to explore and delineate the content of consultations conducted via email in English general practice by conducting a content analysis of email consultations between general practitioners (GPs) and patients. Methods We conducted a content analysis of anonymized email consultations between GPs and patients in 2 general practices in the United Kingdom. We examined the descriptive elements of the correspondence to ascertain when the emails were sent, the number of emails in an email consultation, and the nature of the content. We used a normative approach to analyze the content of the email consultations to explore the use and function of email consultation. Results We obtained 100 email consultations from 85 patients, which totaled 262 individual emails. Most email users were older than 40 years, and over half of the users were male. The email consultations were mostly short and completed in a few days. Emails were mostly sent and received during the day. The emails were mostly clinical in content rather than administrative and covered a wide range of clinical presentations. There were 3 key themes to the use and function of the email consultations: the role of the GP and email consultation, the transactional nature of an email consultation, and the operationalization of an email consultation. Conclusions Most cases where emails are used to have a consultation with a patient in general practice have a shorter consultation, are clinical in nature, and are resolved quickly. GPs approach email consultations using key elements similar to that of the face-to-face consultation; however, using email consultations has the potential to alter the role of the GP, leading them to engage in more administrative tasks than usual. Email consultations were not a replacement for face-to-face consultations.

Style APA, Harvard, Vancouver, ISO itp.

2

Prathivadi Bhayankaram, N., R. J. Lacey, L. A. Barnett, K. P. Jordan i K. M. Dunn. "Musculoskeletal consultations from childhood to adulthood: a longitudinal study". Journal of Public Health 42, nr 4 (28.11.2019): e428-e434. http://dx.doi.org/10.1093/pubmed/fdz141.

Pełny tekst źródła

Streszczenie:

Abstract Background The Global Burden of Disease reports indicate that musculoskeletal conditions are important causes of disability worldwide. Such conditions may originate in childhood, but studies investigating changes longitudinally and from childhood to adulthood are infrequent. Methods Nine birth cohorts of children (starting at ages 7–15 years) were followed. Participants were identified from Consultations in Primary Care Archive, an electronic health record database of 11 English general practices. Musculoskeletal consultation prevalence figures were calculated, and reasons for consultation evaluated. Results Annual musculoskeletal consultation prevalence was similar across cohorts for each age. Prevalence increased from 6 to 16% between ages 7 and 22 and was higher in males until age 15, after which prevalence was higher in females. Pain was the most common reason for consultation. Back pain consultations increased from 1 consultation/1000 7 year olds to 84 consultations/1000 22 year olds. Lower limb pain consultations increased from 21 consultations/1000 7 year olds to 56 consultations/1000 22 year olds. Conclusions This study shows that from childhood, individuals are more likely to seek healthcare for musculoskeletal consultations as they age, but rates are not increasing over time. Changes in consultation rates by age, gender and pain region may inform studies on the development of chronic musculoskeletal pain over the life-course.

Style APA, Harvard, Vancouver, ISO itp.

3

Henry, Heather. "Remote asthma consultations in primary care". Practice Nursing 32, nr 1 (2.01.2021): 10–14. http://dx.doi.org/10.12968/pnur.2021.32.1.10.

Pełny tekst źródła

Streszczenie:

The COVID-19 pandemic has accelerated the move towards remote clinical consultations. Heather Henry explains how remote asthma consultations can be conducted effectively The COVID-19 pandemic has lead to a rapid increase in remote clinical consultations. Telephone, text messaging and video-based consultations reduce the need for face-to-face consultations that might increase the risk of infection. Appropriate triage is key to the safety of remote consultations. The evidence so far is that, with careful triage, remote consultations are as effective as traditional face-to-face consultations and could be more resource and time effective both for nurses and patients. There are pros and cons to each method of remote consultation. This article will look at the technique for conducting a successful video consultation.

Style APA, Harvard, Vancouver, ISO itp.

4

Babaniamansour, Sepideh. "The Quality of Medical Consultations in a Teaching Hospital: A Cross-Sectional Study". Journal of Biomedical Research & Environmental Sciences 2, nr 5 (maj 2021): 392–98. http://dx.doi.org/10.37871/jbres1247.

Pełny tekst źródła

Streszczenie:

Background and objectives: Medical consultations became undeniable elements for the quality of health care and training of medical residence. This study aimed to assess the quality of performed consultations. Methods: This retrospective cross-sectional study at Shohadaye Tajrish hospital, affiliated to Shahid Beheshti University of Medical Sciences, in Tehran, Iran between 20th April 2018 and 4th May 2019. The reported items and quality score of medical consultation requests and responses between emergency and non-emergency consultations and between the faculty members and medical residents were assessed by SPSS version 21.0. Results: Among 431 medical consultations, most were non-emergency, requested by residents, and responded to by faculty members. The quality of consultations requested (p < 0.001) or responded (p < 0.001) by faculty members was higher than by medical residents. Higher year residents performed higher quality consultation requests (p = 0.008) and responses (p < 0.001). The quality score of consultation requests (p = 0.51) and responses (p = 0.1) had no significant difference between types of consultation. Conclusion: Underreported items of consultation impressed its quality. Faculty members and higher-year residents performed higher quality consultations.

Style APA, Harvard, Vancouver, ISO itp.

5

Schmidt, Robert L., Christopher A. Garcia, Jeanne Panlener, Edward R. Ashwood, Brian R. Jackson i Jerry W. Hussong. "An Analysis of Clinical Consultation Activities in Clinical Chemistry: Implications for Transformation and Resident Training in Chemical Pathology". Archives of Pathology & Laboratory Medicine 138, nr 5 (1.05.2014): 671–77. http://dx.doi.org/10.5858/arpa.2013-0017-oa.

Pełny tekst źródła

Streszczenie:

Context.—Clinical consultation is a key role of pathologists. Many have advocated that pathologists expand their consulting activities to improve laboratory utilization. Although many have suggested that residency programs need to provide experience in clinical consultation, little has been written on the nature of consultation or on the methods of training. Objective.—To characterize the content of consultations and to describe training in consultation in chemical pathology within the residency program at the University of Utah, Salt Lake City. Design.—Retrospective review of the consultation database for the period between July 2011 and July 2012. Results.—Residents performed an average of 159 consultations a month covering 276 topics during the course of a year. Each topic involved 1 or more specific tests. Eighty percent of the topics received fewer than 12 calls. The most common topics involved virus testing (eg, hepatitis B virus, hepatitis C virus, human immunodeficiency virus). Consultations most often involved test interpretation (53%), selection (38%), and performance characteristics (21%). Twenty-seven percent of consultations involved 2 or more consultation categories (eg, interpretation and performance). Conclusions.—Consultation calls in chemical pathology are widely distributed across topics. Consultations most often involve test interpretation and selection. Methods to assess the effectiveness of consultations and resident teaching should be devised.

Style APA, Harvard, Vancouver, ISO itp.

6

Fan, Xiucong, Danxia Chen, Siwei Bao, Rong Bai, Fang Fang, Xiaohui Dong, Yuyi Zhang, Xiaogang Zhang, Yabin Ma i Xiaobo Zhai. "Integrating Multidisciplinary Individualized Medication Recommendations Into the Traditional Pharmacists’ Consultation Method: A Retrospective Study Using Propensity Score Matching Analysis". INQUIRY: The Journal of Health Care Organization, Provision, and Financing 59 (styczeń 2022): 004695802210814. http://dx.doi.org/10.1177/00469580221081437.

Pełny tekst źródła

Streszczenie:

Chinese clinical pharmacists consider improving the quantity and quality of consultations to be an important task in providing better pharmaceutical care. To achieve this goal, we developed a clinical pharmacist consultation method using multidisciplinary individualized medication recommendations (MIMRs) and studied the effects of its implementation. A retrospective study of 812 clinical pharmacist-led consultations was conducted. In the pre-intervention group, medication advice was given based on the purpose of the consultation. In the post-intervention group, a consultation method using MIMRs was implemented, in which clinical pharmacists with specialties in anticoagulation, gastroenterology, and nutrition were asked to give individualized medication recommendations. Outcomes, including the effectiveness rate of consultations (ERC) and acceptance rate of consultations (ARC), were compared between the two groups using propensity score matching method. Patterns and numbers of consultations and individualized medication recommendations were also compared. The results showed that the ERC in the post-intervention group compared with the ERC in the pre-intervention group was 83.3% vs 74.0%, respectively (P < .05). Significant difference was also shown between the two groups in ARC (98.4% vs 92.2%, P < .05). The total number of consultations increased, as did the number of general consultations, multidisciplinary/difficult consultations, anti-infection consultations, and non–anti-infection consultations specifically. As a result, we proposed that the implementation of MIMRs can improve the effects of treatment and increase the number of consultations by pharmacists, which is worthy of further promotion to better serve physicians and patients.

Style APA, Harvard, Vancouver, ISO itp.

7

Saraswat, Charvi, i Catherine Bright. "Review of Remote Consultations in Learning Disability During COVID Pandemic". BJPsych Open 8, S1 (czerwiec 2022): S144—S145. http://dx.doi.org/10.1192/bjo.2022.415.

Pełny tekst źródła

Streszczenie:

AimsThe aim of this project was to assess the efficacy of remote consultations in patients with Learning Disability (LD). In Aneurin Bevan University Health Board, teleconsultation or “Attend Anywhere” (Video) platforms are the two types of remote consultation that is being offered.MethodsA 9- point Questionnaire was used to assess the efficiency of the consultation. During consultation (Either telephone or attend anywhere), data were collected by the consultants by answering the questionnaire. 23 clinics organised between 04/06/2020 to 23/06/2020 for Service Users' (SU) follow-up.The following key points were covered in the questionnaire: 1.Mode of consultation- telephone or attend anywhere2.Presence of the SU3.Introduction4.Availability of information (patient notes/shared drives) prior to consultation5.Time constraints6.Information not covered due to lack of face-to-face consult7.Technical difficulties8.Expectations from SU9.Feedback from SUResults1.The most common mode of consultation was via telephone (70%), followed by Attend Anywhere (30%)2.The majority of conversations were with SU's family or carers (70%); consultations with SU were only 30%. SU were unable to attend the consultation due to: Communication difficulty (26%), follow-ups provided by carer's/family's feedback (21.7%), SU away due to physical health reasons, or in day care (17.3%).3.Introductions were done and sufficient information regarding the service users were available in all consultations.4.Expectation of SU/carers/family was with regards to medication review (43%).5.52% of remote consultation were disrupted due to technical problems, for instance call drops and line disruptions, microphone issues and SU not being able to use attend anywhere because of its complexity.ConclusionIt was demonstrated that remote consultation could possibly be most effective for medication reviews or regular follow-up appointments.Some of the aspects that were not covered due to the shortcomings of remote consultations were: a.Difficulty in assessing body language and facial expressionsb.Difficulty in assessing the level of function of SUc.Unable to monitor physical health parametersd.Difficulty in picking up non-verbal cues, and assess eye contact to ascertain mood component of presentation.In summary it seems in the early stages of the pandemic, telephone consultation was the predominant form of remote consultation. Further work would be useful to obtain the views of people with LD, their carers and families as to which form of consultation would be their preference and whether remote consultation is acceptable for this patient group.

Style APA, Harvard, Vancouver, ISO itp.

8

Bavngaard, Martin Vinther, Elle Christine Lüchau, Elisabeth Assing Hvidt i Anette Grønning. "Exploring patient participation during video consultations: A qualitative study". DIGITAL HEALTH 9 (styczeń 2023): 205520762311806. http://dx.doi.org/10.1177/20552076231180682.

Pełny tekst źródła

Streszczenie:

Objective Video consultations enable a digital point of contact between the general practitioner and patient. With their medium-specific characteristics, video consultations may create novel conditions for the enactment of patient participation during consultations. Although numerous studies have explored patients’ experiences of video consultations, research explicitly investigating patient participation within this new consultation setting remains sparse. This qualitative study explores how patients participate during interactions with their general practitioner by drawing on the affordances of video consultations. Methods The data corpus comprises eight recorded video consultations (59 minutes and 19 seconds in total) between patients and their general practitioner, all subjected to reflexive thematic analysis yielding three themes illustrating concrete participatory use cases. Results We find that video consultations provide an accessible format for patients otherwise unable to attend a physical consultation due to physical and mental barriers. Moreover, patients participate by drawing on resources situated in their spatial setting to settle health-related questions of doubt arising during the consultation. Lastly, we posit that patients enact participation by visually communicating their impromptu engagement in decision-making and reporting to their general practitioner by making use of the qualities of their smartphone during their consultation. Conclusions Our findings illustrate how video consultations provide a communicative context in which patients may enact distinct forms of participation by drawing on its technologically contingent affordances during interactions with their general practitioner. More research is needed to explore the participatory opportunities of video consultations in telemedical healthcare services for different patient groups.

Style APA, Harvard, Vancouver, ISO itp.

9

Rungby, Jeanne A., Frans Rømeling i Peter Borum. "Tonsillectomy: assessment of quality by consultation rate after discharge". Journal of Laryngology & Otology 113, nr 2 (luty 1999): 135–39. http://dx.doi.org/10.1017/s0022215100143385.

Pełny tekst źródła

Streszczenie:

AbstractThe aim of this prospective study was to establish a measure of short-term quality of treatment after tonsillectomy/adenotonsillectomy. One hundred and thirty-four questionnaires, returned after 14 days, from 41 children and 93 adults were analysed. Forty-seven per cent had one or more consultations with health-care professionals. Eighty-three consultations by telephone and 33 consultations in person were made. Two recent studies reported higher consultation rates in person to doctors compared to this study. The predominant reason for consulting health-care professionals was pain. Maximum pain scores were significantly higher among those with consultations vs. no consultations (p = 0.0001). Additionally, the intensity as well as the duration of maximal pain increased with the number of contacts per patient (p = 0.0001, p = 0.0045). Sixty-four per cent felt relieved after consultation by telephone and 83 per cent felt relieved after consultation in person. The present study suggests consultation rate as a parameter of quality of treatment and quality of information.

Style APA, Harvard, Vancouver, ISO itp.

10

Johnson, Laura S., Jason Lesandrini i Grace S. Rozycki. "Use of the Medical Ethics Consultation Service in a Busy Level I Trauma Center: Impact on Decision-Making and Patient Care". American Surgeon 78, nr 7 (lipiec 2012): 735–40. http://dx.doi.org/10.1177/000313481207800709.

Pełny tekst źródła

Streszczenie:

The purposes of this study were to assess reasons for consultation of the Ethics Consultation Service for trauma patients and how consultations impacted care. We conducted a review of ethics consultations at a Level I trauma center from 2001 to 2010. Data included patient demographics, etiology of injury, and timing/type of the consult, categorized as: shared decision-making, end-of-life, privacy and confidentiality, resource allocation, and professionalism. Consultations were requested on 108 patients (age mean, 46.5 ± 20 years; Injury Severity Score mean, 23 ± 14; length of stay [LOS] mean, 44 ± 44 days), 0.50 per cent of all trauma admissions. Seventy-seven per cent of consultations occurred in the intensive care unit. End of life was the most common consultation (44%) followed by shared decision-making (41%). Average time to consultation was 25 days. Shared decision-making consults occurred much earlier than end-of-life consults as evidenced by a lower consult day/LOS ratio (consult day/LOS = 0.36 ± 0.3 vs 0.77 ± 0.3, P = 0.0001). Conclusions consisted of: 1) ethics consultation on trauma patients are most commonly for end-of-life and shared decision-making issues; 2) most ethics consultations occur while patients are in the intensive care unit; and 3) earlier ethics consultations are likely to be for shared decision-making issues.

Style APA, Harvard, Vancouver, ISO itp.

11

Farr, Michelle, Jonathan Banks, Hannah B. Edwards, Kate Northstone, Elly Bernard, Chris Salisbury i Jeremy Horwood. "Implementing online consultations in primary care: a mixed-method evaluation extending normalisation process theory through service co-production". BMJ Open 8, nr 3 (marzec 2018): e019966. http://dx.doi.org/10.1136/bmjopen-2017-019966.

Pełny tekst źródła

Streszczenie:

ObjectivesTo examine patient and staff views, experiences and acceptability of a UK primary care online consultation system and ask how the system and its implementation may be improved.DesignMixed-method evaluation of a primary care e-consultation system.SettingPrimary care practices in South West England.MethodsQualitative interviews with 23 practice staff in six practices. Patient survey data for 756 e-consultations from 36 practices, with free-text survey comments from 512 patients, were analysed thematically. Anonymised patients’ records were abstracted for 485 e-consultations from eight practices, including consultation types and outcomes. Descriptive statistics were used to analyse quantitative data. Analysis of implementation and the usage of the e-consultation system were informed by: (1) normalisation process theory, (2) a framework that illustrates how e-consultations were co-produced and (3) patients’ and staff touchpoints.ResultsWe found different expectations between patients and staff on how to use e-consultations ‘appropriately’. While some patients used the system to try and save time for themselves and their general practitioners (GPs), some used e-consultations when they could not get a timely face-to-face appointment. Most e-consultations resulted in either follow-on phone (32%) or face-to-face appointments (38%) and GPs felt that this duplicated their workload. Patient satisfaction of the system was high, but a minority were dissatisfied with practice communication about their e-consultation.ConclusionsWhere both patients and staff interact with technology, it is in effect ‘co-implemented’. How patients used e-consultations impacted on practice staff’s experiences and appraisal of the system. Overall, the e-consultation system studied could improve access for some patients, but in its current form, it was not perceived by practices as creating sufficient efficiencies to warrant financial investment. We illustrate how this e-consultation system and its implementation can be improved, through mapping the co-production of e-consultations through touchpoints.

Style APA, Harvard, Vancouver, ISO itp.

12

Verma, Rhea, Tamar Krishnamurti i Kristin N. Ray. "Parent Perspectives on Family-Centered Pediatric Electronic Consultations: Qualitative Study". Journal of Medical Internet Research 22, nr 4 (9.04.2020): e16954. http://dx.doi.org/10.2196/16954.

Pełny tekst źródła

Streszczenie:

Background Electronic consultations, which use store-and-forward transfer of clinical information between a primary care physician and a specialist, improve access to specialty care. Adoption of electronic consultations is beginning in pediatric health care systems, but little is known about parent perspectives, informational needs, and preferences for interaction with this new model of care. Objective This study aimed to examine parent perspectives about electronic consultations, including perceived benefits and risks, anticipated informational needs, and preferences for parent engagement with electronic consultations. Methods We recruited caregivers of pediatric patients (aged 0-21 years) attending visits at an academic primary care center. Caregivers were eligible if their child had ever been referred for in-person specialty care. Caregivers participated in a semistructured interview about electronic consultations, including general perspectives, desired information, and preferences for parental engagement. Interviews were transcribed and qualitatively analyzed to identify parent perspectives on electronic consultations in general, information parents would like to receive about electronic consultations, and perspectives on opportunities to enhance parent engagement with electronic consultations. Results Interviewees (n=20) anticipated that electronic consultations would reduce the time burden of specialty care on families and that these had the potential to improve the integrity and availability of clinical information, but interviewees also expressed concern about data confidentiality. The most detailed information desired by interviewees about electronic consultations related to data security, including data confidentiality, availability, and integrity. Interviewees expressed concern that electronic consultations could exclude parents from their child’s health care decisions. Interviewees saw value in the potential ability to track the consultation status or to participate in the consultation dialogue, but they were more ambivalent about the idea of read-only access to consultation documentation. Conclusions Parents identified the potential risks and benefits of pediatric electronic consultations, with implications for communication with families about electronic consultations and for incorporation of features to enhance parent engagement.

Style APA, Harvard, Vancouver, ISO itp.

13

Taylor, Michael J., Dell Horey, Charles Livingstone, Siew-Pang Chan i Hal Swerissen. "General practitioners and consultation drift: the effects of supply-side changes and reforms on service delivery patterns". Australian Health Review 37, nr 5 (2013): 574. http://dx.doi.org/10.1071/ah12160.

Pełny tekst źródła

Streszczenie:

Objectives To determine what types of supply-side change underpinned the recent decline in longer (Level C and D) consultation provision and to evaluate the impact of the May 2010 reforms in realigning Medicare with long-term health policy objectives. Methods Retrospective analysis of Level C and D consultation provision by general practitioners (GPs) across Australia. Outcome measures were extent (number of consultations per providing GP) and participation (proportion of GPs providing these consultations). Results The proportion of GPs participating in Level C consultation provision is substantial (96%) and constant; however, extent of provision per GP decreased by 21% between 2006 and 2010. Level D participation decreased from 72% during 2006 to a nadir of 62% in 2009, and extent of provision decreased by 26% between 2006 and 2010. Conclusion Two distinct types of change underpinned the overall decline in Level C and D consultation provision. GPs appear to be providing Level C consultations less often, but the overwhelming majority still provide these consultations to some extent. The extent of provision of Level D consultations and the proportion of GPs providing them has decreased; an appreciable number of GPs simply stopped providing Level D consultations. Medicare reforms appear ineffective in realigning Medicare with long-term policy objectives. What is known about the topic? Previous research has demonstrated that GP consultation delivery patterns under Medicare have changed profoundly in recent years, with provision of Level C and D GP consultations having declined substantially. What does this paper add? This research shows that the overall decline in longer consultations is underpinned by distinct supply-side changes: (1) a decrease in average consultation provision per GP (for Levels C and D) and (2) the effective abandonment of Level D consultations by GPs. Medicare reforms do not appear to be entirely effective in addressing these supply changes. What are the implications for practitioners? Despite their centrality to health policy objectives of improved preventive care, chronic disease management and mental healthcare, longer GP consultations are declining in very distinct ways. The ability of the current Medicare model to achieve these health policy objectives appears increasingly questionable.

Style APA, Harvard, Vancouver, ISO itp.

14

Kontopantelis, Evangelos, Maria Panagioti, Tracey Farragher, Luke A. Munford, Rosa Parisi, Claire Planner, Sharon Spooner, Alice Tse, Darren M. Ashcroft i Aneez Esmail. "Consultation patterns and frequent attenders in UK primary care from 2000 to 2019: a retrospective cohort analysis of consultation events across 845 general practices". BMJ Open 11, nr 12 (grudzień 2021): e054666. http://dx.doi.org/10.1136/bmjopen-2021-054666.

Pełny tekst źródła

Streszczenie:

ObjectiveTo describe the distribution of consultations at the practice level and examine whether increases are uniform or driven by people who consult more frequently.DesignRetrospective cohort study.SettingUK general practice data from the Clinical Practice Research Datalink (CPRD) GOLD database.Participants1 699 709 314 consultation events from 12 330 545 patients, in 845 general practices (1 April 2000 to 31 March 2019).MethodsConsultation information was aggregated by financial year into: all consultations/all staff; all consultations/general practitioners (GPs); face-to-face consultations/all staff; face-to-face consultations/GPs. Patients with a number of consultations above the 90th centile, within each year, were classified as frequent attenders. Negative binomial regressions examined the association between available practice characteristics and consultation distribution.ResultsAmong frequent attenders, all consultations by GPs increased from a median (25th and 75th centile) of 13 (10 and 16) to 21 (18 and 25) and all consultations by all staff increased from 27 (23–30) to 60 (51–69) over the study period. Approximately four out of ten consultations of any type concerned frequent attenders and the proportion of consultations attributed to them increased over time, particularly for face-to-face consultations with GPs, from a median of 38.0% (35.9%–40.3%) in 2000–2001 to 43.0% (40.6%–46.4%) in 2018–2019. Regression analyses indicated decreasing trends over time for face-to-face consultations and increasing trends for all consultation types, for both GPs and all staff. Frequent attenders consulted approximately five times more than the rest of the practice population, on average, with adjusted incidence rate ratios ranging between 4.992 (95% CI 4.917 to 5.068) for face-to-face consultations with all staff and 5.603 (95% CI 5.560 to 5.647) for all consultations with GPs.ConclusionsFrequent attenders progressively contributed to increased workload in general practices across the UK from 2000 to 2019. Important knowledge gaps remain in terms of the demographic, social and health characteristics of frequent attenders and how UK general practices can be prepared to meet the needs of these patients.

Style APA, Harvard, Vancouver, ISO itp.

15

Quiroz, Juan C., Liliana Laranjo, Ahmet Baki Kocaballi, Agustina Briatore, Shlomo Berkovsky, Dana Rezazadegan i Enrico Coiera. "Identifying relevant information in medical conversations to summarize a clinician-patient encounter". Health Informatics Journal 26, nr 4 (29.08.2020): 2906–14. http://dx.doi.org/10.1177/1460458220951719.

Pełny tekst źródła

Streszczenie:

To inform the development of automated summarization of clinical conversations, this study sought to estimate the proportion of doctor-patient communication in general practice (GP) consultations used for generating a consultation summary. Two researchers with a medical degree read the transcripts of 44 GP consultations and highlighted the phrases to be used for generating a summary of the consultation. For all consultations, less than 20% of all words in the transcripts were needed for inclusion in the summary. On average, 9.1% of all words in the transcripts, 26.6% of all medical terms, and 27.3% of all speaker turns were highlighted. The results indicate that communication content used for generating a consultation summary makes up a small portion of GP consultations, and automated summarization solutions—such as digital scribes—must focus on identifying the 20% relevant information for automatically generating consultation summaries.

Style APA, Harvard, Vancouver, ISO itp.

16

KUSHNIRIUK, Volodymyr, Oleh SERNIAK i Tetiana SHUSHAILO. "THEORETICAL AND LEGAL BASIS OF PUBLIC CONSULTATIONS IN UKRAINE". Coordinates of Public Administration, nr 1 (7.03.2024): 77–97. http://dx.doi.org/10.62664/cpa.2023.01.04.

Pełny tekst źródła

Streszczenie:

One of the methods of involving the public in the formation of public policy, which is widely used in democratic countries, is public consultation. It is a tool that develops dialogue and trust between all participants in this process and makes the development and adoption of reforms more relevant to the demands of their consumers. The culture of public consultations in Ukraine is only gaining popularity, and therefore it is very important to form the conceptual, methodological and legal basis of this participation mechanism. Foreign and domestic approaches to understanding public consultations are considered. On their basis, the key characteristics of public consultations were formed, namely: the two-way nature of communication between a public institution and interested citizens; application both during the development of policies and at the stages of their updating and implementation; completeness by the adoption of a decision or the adoption of a normative legal act, which necessarily takes into account the suggestions of the public; initiation of the consultation by issuing an official document by the authority (resolution, order, etc.) that describes in detail the content and terms of the public consultation; the obligation to include in the target audiences of public consultations citizens, groups of persons, legal entities that are tangential to this policy, who will be the first to use the services that will arise as a result of the implementation of the policy, as well as independent experts and representatives of public organizations. The history of the formation of Ukrainian legislation on public consultations is analysed. The differences between the current draft of the Law on Public Consultations compared to the 2016 draft are highlighted, namely: the presence of a non-exhaustive list of subjects of power; identification of parties interested in public consultations; supplementing the forms of conducting public consultations with targeted consultations; replacement of the Information Register of interested persons with an online platform for interaction with citizens and institutions of civil society; lack of disciplinary responsibility for violation of the requirements of the law for officials of subjects of power, who are responsible for conducting public consultations; reducing the number of principles of conducting public consultations from seven to six and adding the principle of proportionality instead of the principles of the rule of law and legality. It has been established that the procedure for conducting them proposed in the draft Law on public consultations meets international standards and good practices and existing theoretical and methodological developments and covers the following stages: drawing up a plan for conducting public consultations; drawing up a consultation document; publication of a consultation document; provision of informing interested parties about holding public consultations; holding events within the framework of public consultations; publication of proposals received during public consultations; study and analysis of proposals; publication of the report on the results of public consultations and the final draft of the regulatory and legal document.

Style APA, Harvard, Vancouver, ISO itp.

17

Butcher, Paul, i Simona Pronckutė. "European Citizens’ Consultations: Consultation begins at home". European View 18, nr 1 (kwiecień 2019): 80–88. http://dx.doi.org/10.1177/1781685819847637.

Pełny tekst źródła

Streszczenie:

In 2018 the European Citizens’ Consultations took place throughout Europe. These events were organised by national governments and local actors, and thus represented a significantly increased role for the member states in communicating about Europe, a task which had previously been carried out chiefly by EU bodies. Thus, the Citizens’ Consultations hold great potential for the application of the principle of subsidiarity to citizens’ engagement and inclusion in decision-making. However, for the consultations to be successful, political leaders need to ensure that the results are reflected in the European Parliament election campaign and the agenda of the new leadership, demonstrating that citizens’ voices are being heard in Brussels. This article will give background information about the European Citizens’ Consultations, evaluate their potential and provide recommendations on how policymakers can ensure this new tool is used effectively.

Style APA, Harvard, Vancouver, ISO itp.

18

Loula, P., E. Rauhala, M. Erkinjuntti, E. Raty, K. Hirvonen i V. Hakkinen. "Distributed clinical neurophysiology". Journal of Telemedicine and Telecare 3, nr 2 (1.06.1997): 89–95. http://dx.doi.org/10.1258/1357633971930922.

Pełny tekst źródła

Streszczenie:

We have developed a consultation forum for clinical neurophysiology in Finland. The system connects local digital electroencephalography EEG recording and analysing networks using a high-speed asynchronous transfer mode ATM network. Clinicians can obtain a second opinion using interactive data and video consultations or using data-only consultations. In addition, the system can be used for off-line review of prerecorded data. During a one-month evaluation, 66 EEG recordings were made altogether in Satakunta Central Hospital and consultations were required on 12 occasions. Nine of them were data-only consultations and three were data and video consultations. A data consultation lasted 15-20 min and a data and video consultation 35-45 min. Clinically, there were numerous benefits for the hospitals. The system established a link to a centre of excellence for second opinions or continuing education. It also helped with on-duty arrangements and enabled the construction of national data banks.

Style APA, Harvard, Vancouver, ISO itp.

19

Stevens, Sarah, Clare Bankhead, Toqir Mukhtar, Rafael Perera-Salazar, Tim A. Holt, Chris Salisbury i F. D. Richard Hobbs. "Patient-level and practice-level factors associated with consultation duration: a cross-sectional analysis of over one million consultations in English primary care". BMJ Open 7, nr 11 (listopad 2017): e018261. http://dx.doi.org/10.1136/bmjopen-2017-018261.

Pełny tekst źródła

Streszczenie:

ObjectivesConsultation duration has previously been shown to be associated with patient, practitioner and practice characteristics. However, previous studies were conducted outside the UK, considered only small numbers of general practitioner (GP) consultations or focused primarily on practitioner-level characteristics. We aimed to determine the patient-level and practice-level factors associated with duration of GP and nurse consultations in UK primary care.Design and settingCross-sectional data were obtained from English general practices contributing to the Clinical Practice Research Datalink (CPRD) linked to data on patient deprivation and practice staffing, rurality and Quality and Outcomes Framework (QOF) achievement.Participants218 304 patients, from 316 English general practices, consulting from 1 April 2013 to 31 March 2014.AnalysisMultilevel mixed-effects models described the association between consultation duration and patient-level and practice-level factors (patient age, gender, smoking status, ethnic group, deprivation and practice rurality, number of full-time equivalent GPs/nurses, list size, consultation rate, quintile of overall QOF achievement and training status).ResultsMean duration of face-to-face GP consultations was 9.24 min and 5.32 min for telephone consultations. Nurse face-to-face and telephone consultations lasted 9.70 and 5.73 min on average, respectively. Longer GP consultation duration was associated with female patient gender, practice training status and older patient age. Shorter duration was associated with higher deprivation and consultation rate. Longer nurse consultation duration was associated with male patient gender, older patient age and ever smoking; and shorter duration with higher consultation rate. Observed differences in duration were small (eg, GP consultations with female patients compared with male patients were 8 s longer on average).ConclusionsSmall observed differences in consultation duration indicate that patients are treated similarly regardless of background. Increased consultation duration may be beneficial for older or comorbid patients, but the benefits and costs of increased consultation duration require further study.

Style APA, Harvard, Vancouver, ISO itp.

20

Oh, Daniel J., Levi N. Kanu, Judy L. Chen, Ahmad A. Aref, William F. Mieler i Peter W. MacIntosh. "Inpatient and Emergency Room Ophthalmology Consultations at a Tertiary Care Center". Journal of Ophthalmology 2019 (14.02.2019): 1–7. http://dx.doi.org/10.1155/2019/7807391.

Pełny tekst źródła

Streszczenie:

Background. An ophthalmology consultation service is of significant benefit to patients in the hospital and is an instructive component of a residency education program. Ophthalmology consultations in a hospital present unique challenges to those seen in an outpatient clinic, for which the consulting ophthalmologist should be prepared. The purpose of this study was to profile the emergency room and inpatient ophthalmology consultations seen at an academic institution. Methods. A prospective study of 581 patients was conducted on inpatient and emergency room ophthalmology consultations at the University of Illinois at Chicago over twelve months. Characteristics such as the consulting service, type of and reason for consultation, subspecialty staffing service, diagnosis, and suitability for in-hospital evaluation were recorded. Results. Consultations were received from either inpatient wards (59.4%) or the Emergency Department (40.6%). The most common inpatient consulting services were internal medicine (22%), followed by neurosurgery (16%) and neurology (7%). All the consultations were categorized as acute (72.3%), chronic (6.0%), or screening (21.7%). Consultations categorized as screening included papilledema (31.0%), fungemia (20.6%), syndromic evaluation (19.8%), visual field evaluation (17.5%), and miscellaneous evaluation (11.1%). We classified the ophthalmic diagnoses into 63 unique diagnoses. Amongst the ophthalmic subspecialties, neuro-ophthalmologic diagnoses were the most common (32.0%), followed by retina (20.1%) and cornea (19.4%). Neuro-ophthalmology had the highest proportion of screening consultations (36.6%), while glaucoma had the least overall number of consultations (10.1%), and the least proportion of screening consultations (3.6%). A significant proportion of nonacute consultations (19.0%) was deemed to be more suitable for outpatient evaluation. Discussion. Consultation databases can be useful in preparing trainees for in-hospital clinical care. A wide range of ocular pathologies may present to the ophthalmology consultant, from acute trauma to screening for systemic syndromes. Some consultations may be more suitable for outpatient evaluation which may help optimize patient care.

Style APA, Harvard, Vancouver, ISO itp.

21

Emberland, Knut Erik, Knut-Arne Wensaas, Sverre Litleskare i Guri Rortveit. "Consultations for gastroenteritis in general practice and out-of-hours services in Norway 2006–15". Family Practice 36, nr 5 (26.01.2019): 614–20. http://dx.doi.org/10.1093/fampra/cmy133.

Pełny tekst źródła

Streszczenie:

Abstract Background Most of the patients with gastroenteritis seeking health care services are managed in primary care; yet, little is known about these consultations. Syndromic-based surveillance of gastrointestinal infections is used in several countries, including Norway. Aim To investigate the extent of, and explore characteristics associated with, consultations for gastroenteritis in primary care and to compare consultations in daytime general practice and out-of-hours (OOH) services in Norway. Design and Setting Registry-based study using reimbursement claims data from all consultations in general practice and OOH services in Norway over the 10-year period, 2006–15. Methods The main outcome variable was whether the consultation took place in general practice or OOH services. Possible associations with patient age and sex, time and use of point-of-care C-reactive protein (CRP) testing and sickness certificate issuing were investigated. Results Gastroenteritis consultations (n = 1 281 048) represented 0.9% of all consultations in primary care (n = 140 199 637), of which 84.4% were conducted in general practice and 15.6% in OOH services. Young children and young adults dominated among the patients. Point-of-care CRP testing was used in 36.1% of the consultations. Sickness certificates were issued in 43.6% of consultations with patients in working age. Age-specific time variations in consultation frequencies peaking in winter months were observed. Conclusions The proportion of gastroenteritis consultations was higher in the OOH services when compared with daytime general practice. Young children and young adults dominated among the patients. The seasonal variation in consultation frequency is similar to that shown for gastroenteritis caused by norovirus.

Style APA, Harvard, Vancouver, ISO itp.

22

Álvarez-Dobaño, José Manuel, Malena Toubes, José Ángel Novo-Platas, Francisco Reyes-Santías, Gerardo Atienza, Manuel Portela, Carlos Rábade i in. "Cost-Effectiveness of a New Outpatient Pulmonology Care Model Based on Physician-to-Physician Electronic Consultation". Canadian Respiratory Journal 2022 (31.10.2022): 1–10. http://dx.doi.org/10.1155/2022/2423272.

Pełny tekst źródła

Streszczenie:

Introduction. This study assesses the impact of an electronic physician-to-physician consultation program on the waiting list and the costs of a Pulmonology Unit. Materials and Methods. A prepost intervention study was conducted after a new ambulatory pulmonary care protocol was implemented and the capacity of the unit was adopted. In the new model, physicians at all levels of healthcare send electronic consultations to specialists. Results. In the preintervention year (2019), the Unit of Pulmonology attended 7,055 consultations (466 e-consultations and 6,589 first face-to-face visits), which decreased to 6,157 (3,934 e-consultations and 2,223 first face-to-face visits; 12.7% reduction) in the postintervention year (all were e-consultations). The mean wait time for the first appointment was 25.7 days in 2019 versus 3.2 days in 2021 ( p < 0.001 ). In total, 43.5% of cases were solved via physician-to-physiciane-consultation. A total of 2,223 patients needed a face-to-face visit, with a mean wait time of 7.5 days. The mean of patients in the waiting listing decreased from 450.8 in 2019 to 44.8 in 2021 (90% reduction). The annual time devoted to e-consultations and first face-to-face visits following an e-consultation diminished significantly after the intervention (1,724 hours versus 2,312.8; 25.4% reduction). Each query solved via e-consultation represented a saving of €652.8, resulting in a total annual saving of €827,062. Conclusions. Physician-to-physiciane-consultations reduce waiting times, improve access of complex patients to specialty care, and ensure that cases are managed at the appropriate level. E-consultation reduces costs, which benefits both, society and the healthcare system.

Style APA, Harvard, Vancouver, ISO itp.

23

Glenc, Piotr. "Information and communication technologies in public consultation processes". e-mentor 105, nr 3 (lipiec 2024): 41–50. http://dx.doi.org/10.15219/em105.1670.

Pełny tekst źródła

Streszczenie:

The concept of citizen participation, although not new, continues to be prominently emphasized in contemporary public management theories. One manifestation of citizen participation is involvement in public consultations, which is the focus of this article. The consultation processes evolve alongside the advancing digitalization of public administration. Consequently, many researchers strive to capture the potential of information and communication technologies (ICT) in enhancing public consultation processes and the related decision-making processes in administration. The article presents the results of research aimed at identifying IT solutions that can be utilized in public consultation processes, at the stages of initiating a consultation and conducting the consultation itself. The research was conducted using secondary source analysis. The analyzed sources were resolutions outlining the principles and procedures for conducting public consultations with citizens, adopted in the municipalities of the Śląskie Voivodship, Poland (140 resolutions). Eleven entities (or groups of entities) were identified that, according to the resolutions, have the right to initiate consultations. Most commonly, this right is granted to executive bodies, groups of residents, and municipal councils. Only in one municipality's resolution was the possibility of submitting such an initiative electronically mentioned. The most frequently used methods of conducting consultations, as indicated by the analyzed resolutions, are: surveys, open meetings with residents, and collecting written comments and opinions. 79% of the surveyed units declared the use of at least one method involving IT tools for conducting consultations. 11% of the units declared in their resolutions the implementation of a municipal platform dedicated to public consultations. Only one unit declared the use of a special mobile application for public consultations.

Style APA, Harvard, Vancouver, ISO itp.

24

Huygens, Martine W. J., Ilse C. S. Swinkels, Robert A. Verheij, Roland D. Friele, Onno C. P. van Schayck i Luc P. de Witte. "Understanding the use of email consultation in primary care using a retrospective observational study with data of Dutch electronic health records". BMJ Open 8, nr 1 (styczeń 2018): e019233. http://dx.doi.org/10.1136/bmjopen-2017-019233.

Pełny tekst źródła

Streszczenie:

ObjectivesIt is unclear why the use of email consultation is not more widespread in Dutch general practice, particularly because, since 2006, its costs can be reimbursed. To encourage further implementation, it is needed to understand the current use of email consultations. This study aims to understand the use of email consultation by different patient groups, compared with other general practice (GP) consultations.SettingFor this retrospective observational study, we used Dutch routine electronic health record data obtained from NIVEL Primary Care Database for the years 2010 and 2014.Participants200 general practices were included in 2010 (734 122 registered patients) and 434 in 2014 (1 630 386 registered patients).Primary outcome measuresThe number and percentage of email consultations and patient characteristics (age, gender, neighbourhood socioeconomic status and diagnoses) of email consultation users were investigated and compared with those who had a telephone or face-to-face consultation. General practice characteristics were also taken into account.Results32.0% of the Dutch general practices had at least one email consultation in 2010, rising to 52.8% in 2014. In 2014, only 0.7% of the GP consultations were by email (the others comprised home visits, telephone and face-to-face consultations). Its use highly varied among general practices. Most email consultations were done for psychological (14.7%); endocrine, metabolic and nutritional (10.9%); and circulatory (10.7%) problems. These diagnosis categories appeared less frequently in telephone and face-to-face consultations. Patients who had an email consultation were older than patients who had a telephone or face-to-face consultation. In contrast, patients with diabetes who had an email consultation were younger.ConclusionEven though email consultation was done in half the general practices in the Netherlands in 2014, the actual use of it is extremely low. Patients who had an email consultation differ from those who had a telephone or face-to-face consultation. In addition, the use of email consultation by patients is dependent on its provision by GPs.

Style APA, Harvard, Vancouver, ISO itp.

25

Looi, Jeffrey CL, Stephen Allison, Tarun Bastiampillai i William Pring. "Private practice metropolitan telepsychiatry in smaller Australian jurisdictions during the COVID-19 pandemic: preliminary analysis of the introduction of new Medicare Benefits Schedule items". Australasian Psychiatry 28, nr 6 (5.10.2020): 639–43. http://dx.doi.org/10.1177/1039856220960381.

Pełny tekst źródła

Streszczenie:

Objective: To analyse the smaller Australian state/territory service impact of the introduction of new COVID-19 psychiatrist video and telephone telehealth Medicare Benefits Schedule (MBS) items. Method: MBS item service data were extracted for COVID-19 psychiatrist video and telephone telehealth item numbers corresponding to the pre-existing in-person consultations for the Australian Capital Territory (ACT), Northern Territory (NT), South Australia (SA) and Tasmania. Results: The overall rate of consultations (face-to-face and telehealth) increased during March and April 2020, compared to the monthly face-to-face consultation average, excepting Tasmania. Compared to an annual monthly average of in-person consultations for July 2018–June 2019, total telepsychiatry consultations were higher for April than May. For total video and telephone telehealth consultations combined, video consultations were lower in April and higher in May. As a percentage of combined telehealth and in-person consultations, telehealth was greater for April and lower for May compared to the monthly face-to-face consultation average. Conclusions: In the smaller states/territories, the private practice workforce rapidly adopted COVID-19 MBS telehealth items, with the majority of psychiatric consultation shifting to telehealth initially, and then returning to face-to-face. With a second wave of COVID-19 in Australia, telehealth is likely to remain a vital part of the national mental health strategy.

Style APA, Harvard, Vancouver, ISO itp.

26

van Doorne, Iris, Dick L. Willems, Nadine Baks, Jelle de Kuijper, Bianca M. Buurman i Marjon van Rijn. "Current practice of hospital-based palliative care teams: Advance care planning in advanced stages of disease: A retrospective observational study". PLOS ONE 19, nr 2 (29.02.2024): e0288514. http://dx.doi.org/10.1371/journal.pone.0288514.

Pełny tekst źródła

Streszczenie:

Background Specialist palliative care teams are consulted during hospital admission for advice on complex palliative care. These consultations need to be timely to prevent symptom burden and maintain quality of life. Insight into specialist palliative care teams may help improve the outcomes of palliative care. Methods In this retrospective observational study, we analyzed qualitative and quantitative data of palliative care consultations in a six-month period (2017 or 2018) in four general hospitals in the northwestern part of the Netherlands. Data were obtained from electronic medical records. Results We extracted data from 336 consultations. The most common diagnoses were cancer (54.8%) and organ failure (26.8%). The estimated life expectancy was less than three months for 52.3% of all patients. Within two weeks after consultation, 53.2% of the patients died, and the median time until death was 11 days (range 191) after consultation. Most patients died in hospital (49.4%) but only 7.5% preferred to die in hospital. Consultations were mostly requested for advance care planning (31.6%). End-of-life preferences focused on last wishes and maintaining quality of life. Conclusion This study provides detailed insight into consultations of palliative care teams and shows that even though most palliative care consultations were requested for advance care planning, consultations focus on end-of-life care and are more crisis-oriented than prevention-oriented. Death often occurs too quickly after consultation for end-of-life preferences to be met and these preferences tend to focus on dying. Educating healthcare professionals on when to initiate advance care planning would promote a more prevention-oriented approach. Defining factors that indicate the need for timely palliative care team consultation and advance care planning could help timely identification and consultation.

Style APA, Harvard, Vancouver, ISO itp.

27

Zanaboni, Paolo, Trine S. Bergmo i Eli Kristiansen. "Patients’ experiences with receiving sick leave certificates via remote consultations in Norway during the COVID-19 pandemic: a nationwide online survey". BMJ Open 14, nr 1 (styczeń 2024): e075352. http://dx.doi.org/10.1136/bmjopen-2023-075352.

Pełny tekst źródła

Streszczenie:

ObjectivesTo explore patients’ experiences with receiving sick leave certificates via remote consultations during the COVID-19 pandemic and investigate whether there were differences among the types of remote consultation (telephone, video or text).DesignA nationwide online patient survey consisting of quantitative data supplemented by qualitative opinions conducted in Norway.SettingPrimary care.ParticipantsPatients who received a sick leave certificate via remote consultation in the period from 16 November to 15 December 2020.ResultsOf the 5429 respondents, 3233 (59.6%) received a sick leave certificate via telephone consultation, 657 (12.1%) via video consultation and 1539 (28.3%) via text-based e-consultation. Most respondents (76.8%) were satisfied. Only 10% of the respondents thought that the doctor would have obtained more information through an office appointment. The majority of the respondents (59.6%) found that they had as much time to explain the problem as at an office appointment. Some patients also thought that it was easier to formulate the problem via a remote consultation (18.2%) and agree with the doctor on the sick leave (10.3%).The users of text-based e-consultations were the most satisfied (79.3%, p<0.001) compared with those using telephone or video consultations. Among users of text-based e-consultations, there was a higher proportion of patients who thought that they had more time to explain the problem compared with an office appointment (p<0.001), it was easier to explain the problem (p<0.001) and agree with the doctor (p<0.001). Most respondents would use the same type of remote consultation if they were to contact the general practitioner (GP) for the same problem, with the highest proportion among the users of video consultations (62.1%, p<0.001).ConclusionsPatients were satisfied with communicating and receiving sick leave certificates via remote consultations. Future studies should investigate patients’ and GPs’ use and experiences in a postpandemic setting.

Style APA, Harvard, Vancouver, ISO itp.

28

McCusker, Sarah, Aoife Daly, Natalie King, Manrup Hunjan, Lea Solman, Esther Burden-Teh, Susannah George i Gordon Hale. "P17 A Multisite Service Evaluation of Paediatric Teleconsultations". British Journal of Dermatology 190, Supplement_1 (styczeń 2024): i10. http://dx.doi.org/10.1093/bjd/ljad483.026.

Pełny tekst źródła

Streszczenie:

Abstract Paediatric dermatology teleconsultations have become familiar territory since the Covid-19 pandemic. There is a continued drive to provide teleconsultations, with efficiency and cost-saving cited as benefits. Yet, this is not supported by a recent UK-wide survey of health professionals.1 We evaluated practice across two paediatric dermatology centres, to assess time required for teleconsultations. Data were collected prospectively from paediatric dermatology outpatient consultations for patients <16 years over 2 weeks in March and 4 weeks in September 2022. Consultation type (face-to-face/telephone/video), patient demographics, diagnosis and consultation length were reviewed. Caldicott approval was obtained. A total of 173 consultations were included. There was a range of diagnoses including eczema (n=60), skin lesions (n=22), vascular lesions (n=28) and other inflammatory skin conditions (n=63). Most consultations were face-to-face (n=108, 62%), while 38% (n=65) were teleconsultations. Median consultation duration was 13 minutes, 45 seconds (range: 2.5min–1hour 5min 2s). Comparison of consultation duration across 3 modalities (face-to-face vs telephone vs video) demonstrated no statistical significance between groups. (H(2)=5.76, P=0.056). There was a trend toward significance, likely due to 3 face-to-face consultations with duration of >50 minutes. Limitations include relatively small sample size and consultations carried out by few clinicians. Consultation modality is often influenced by case complexity, i.e., more complex consultations are likely to be held face-to-face. Future work includes a health-economic analysis of teleconsultations to determine if these are cost-effective.

Style APA, Harvard, Vancouver, ISO itp.

29

Alhajri, Noora, Mecit Can Emre Simsekler, Buthaina Alfalasi, Mohamed Alhashmi, Majd AlGhatrif, Nahed Balalaa, Maryam Al Ali i in. "Physicians’ Attitudes Toward Telemedicine Consultations During the COVID-19 Pandemic: Cross-sectional Study". JMIR Medical Informatics 9, nr 6 (1.06.2021): e29251. http://dx.doi.org/10.2196/29251.

Pełny tekst źródła

Streszczenie:

Background To mitigate the effect of the COVID-19 pandemic, health care systems worldwide have implemented telemedicine technologies to respond to the growing need for health care services during these unprecedented times. In the United Arab Emirates, video and audio consultations have been implemented to deliver health services during the pandemic. Objective This study aimed to evaluate whether differences exist in physicians’ attitudes and perceptions of video and audio consultations when delivering telemedicine services during the COVID-19 pandemic. Methods This survey was conducted on a cohort of 880 physicians from outpatient facilities in Abu Dhabi, which delivered telemedicine services during the COVID-19 pandemic between November and December 2020. In total, 623 physicians responded (response rate=70.8%). The survey included a 5-point Likert scale to measure physician’s attitudes and perceptions of video and audio consultations with reference to the quality of the clinical consultation and the professional productivity. Descriptive statistics were used to describe physicians’ sociodemographic characteristics (age, sex, designation, clinical specialty, duration of practice, and previous experience with telemedicine) and telemedicine modality (video vs audio consultations). Regression models were used to assess the association between telemedicine modality and physicians’ characteristics with the perceived outcomes of the web-based consultation. Results Compared to audio consultations, video consultations were significantly associated with physicians’ confidence toward managing acute consultations (odds ratio [OR] 1.62, 95% CI 1.2-2.21; P=.002) and an increased ability to provide patient education during the web-based consultation (OR 2.21, 95% CI 1.04-4.33; P=.04). There was no significant difference in physicians’ confidence toward managing long-term and follow-up consultations through video or audio consultations (OR 1.35, 95% CI 0.88-2.08; P=.17). Video consultations were less likely to be associated with a reduced overall consultation time (OR 0.69, 95% CI 0.51-0.93; P=.02) and reduced time for patient note-taking compared to face-to-face visits (OR 0.48, 95% CI 0.36-0.65; P<.001). Previous experience with telemedicine was significantly associated with a lower perceived risk of misdiagnosis (OR 0.46, 95% CI 0.3-0.71; P<.001) and an enhanced physician-patient rapport (OR 2.49, 95% CI 1.26-4.9; P=.008). Conclusions These results indicate that video consultations should be adopted frequently in the new remote clinical consultations. Previous experience with telemedicine was associated with a 2-fold confidence in treating acute conditions, less than a half of the perceived risk of misdiagnosis, and an increased ability to provide patients with health education and enhance the physician-patient rapport. Additionally, these results show that audio consultations are equivalent to video consultations in providing remote follow-up care to patients with chronic conditions. These findings may be beneficial to policymakers of e-health programs in low- and middle-income countries, where audio consultations may significantly increase access to geographically remote health services.

Style APA, Harvard, Vancouver, ISO itp.

30

Kotwal, Tejas, Kerushan Thomas, Carlos Escudero King i Avirup Gupta. "Assessement of a structured technological support intervention on uptake of video consultations". BJPsych Open 7, S1 (czerwiec 2021): S201—S202. http://dx.doi.org/10.1192/bjo.2021.540.

Pełny tekst źródła

Streszczenie:

AimsThe coronavirus pandemic has led to an increased reliance on remote patient-clinician interactions, mainly the use of telephone and video consultations. Video consultations are key in psychiatric care, as telephone appointments do not sufficiently allow clinicians to accurately ascertain a patient's mental status and perform a risk assessment. The aim of our quality improvement project was to increase the uptake of video consultations within a community mental health team, focusing on substituting telephone consultations for video.MethodWe accessed Electronic Patient Records to retrospectively quantify the method of contact for 130 consultations delivered over a 4-week period. After collecting baseline data, we conducted focused interviews with 10 care providers, identifying the specific clinician and patient barriers to video uptake that informed our intervention design.Our intervention consisted of two 4-week Plan, Do, Study, Act (PDSA) cycles.PDSA 1 involved delivering a focused PowerPoint presentation to the care team, highlighting the benefits of video consultation technology and encouraging clinicians to use it as their primary method of remote communication with patients. Additionally, we conducted qualitative interviews with members of the team to highlight the successes and challenges thus far.PDSA 2 involved creating a video consultation instructional PDF which highlighted how to operate the technological aspects of both Microsoft Teams and WhatsApp Video Call. This included: how to set-up video calls, accept invitations, and overcome common troubleshooting issues.The proportion of remote consultations was quantified retrospectively to compare trends in video consultation uptake from baseline to the conclusion of PDSA 2.ResultOverall, we saw a 15% increase in video consultations with respect to baseline. The greatest change was attributable to PDSA cycle 1, which incurred an 8% increase in video consultation uptake, from 13.85% to 21.9%. PDSA cycle 2 further increased video consultation uptake by 6.97%, from 21.9% to 28.87%. Specifically focusing on remote consultations, the proportion conducted with video rather than telephone increased by 17.3%. Interviewed clinicians reported limited financial access, technological fluency, and issues with patient privacy as the most important barriers to the uptake of video consultations.ConclusionOur project successfully increased the proportion of consultations conducted by video. This was achieved by targeting interventions to address both patient and clinician barriers to video consultation uptake. Moreover, we understand that motivating and mobilising the care team was a key factor. Possible future work includes improving the sustainability of the interventions and assessing their efficacy in other care teams.

Style APA, Harvard, Vancouver, ISO itp.

31

Bang, Min-Jung, So-Kyung Yoon, Kyoung Won Yoon, Eunmi Gil, Keesang Yoo, Kyoung Jin Choi i Chi-Min Park. "Analysis of Medical Consultation Patterns in Medical and Surgical Intensive Care Units: Changes in the Pattern of Consultation after the Implementation of Intensivist-Directed Care". Journal of Acute Care Surgery 11, nr 3 (30.11.2021): 102–7. http://dx.doi.org/10.17479/jacs.2021.11.3.102.

Pełny tekst źródła

Streszczenie:

Purpose: Critically ill patients often require multidisciplinary treatment for both acute illnesses and pre-existing medical conditions. Since different medical conditions are managed in the intensive care unit (ICU), consultation is often required. This study aimed to identify the frequency and type of consultation required and analyze changes in consultation patterns after the introduction of intensivist-directed care in the surgical ICU (SICU).Methods: Between June 2006 and December 2013, a retrospective cohort study was conducted to identify the frequency and type of consultation at 3 different ICUs. Consultations for patients who were admitted to the ICUs for more than 48 consecutive hours were included. The pattern of consultations in each ICU was investigated. In addition, the pattern of consultations before and after the implementation of intensivist-directed care in the SICU was compared.Results: During the study, 11,053 consultations were requested for 7,774 critically ill patients in a total of 3 ICUs. Consultations with the Departments of Cardiology, Infectious Diseases, and Pulmonology were requested most frequently in the SICU. However, after the implementation of the intensivist-directed care approach, there was an increase in the frequency of consultation requests to the Department of Neurology, followed by the Departments of Cardiology, and Infectious Diseases.Conclusion: Analysis of consultation patterns is an important method of assessing the complexity and severity of illnesses, and of evaluating the needs of available health system resources. Based on our findings, we suggest the development of an appropriate protocol for frequently consulted services.

Style APA, Harvard, Vancouver, ISO itp.

32

Kongchan, Chada. "Using Learning Profiles to Inspire Effective Consultations". rEFLections 4 (31.12.2002): 15–30. http://dx.doi.org/10.61508/refl.v4i0.114332.

Pełny tekst źródła

Streszczenie:

While self-directed learning is currently being introduced throughout Thailand in order to encourage students to become autonomous learners, consultations are also emphasized to provide support and give guidance. However, the practical problems of limited time and large numbers of students diminish the potential benefits of consultations. This paper suggests a way to make 5-minute consultations effective by requiring students to attempt peer and self-correction before the consultation and by encouraging the use of learner profiles to guide further learning after the consultation.

Style APA, Harvard, Vancouver, ISO itp.

33

Gulacti, Umut. "Comparison of secure messaging application (WhatsApp) and standard telephone usage for consultations on Length of Stay in the ED". Applied Clinical Informatics 08, nr 03 (2017): 742–53. http://dx.doi.org/10.4338/aci-2017-04-ra-0064.

Pełny tekst źródła

Streszczenie:

Summary Objective: Consultation, the process of an Emergency Physician seeking an opinion from other specialties, occurs frequently in the Emergency Department (ED). The aim of this study was to determine the effect of secure messaging application (WhatsApp) usage for medical consultations on Emergency Department Length of Stay (ED LOS) and consult time. Methods: We conducted a prospective, randomized controlled trial in the ED using allocation concealment over three months. Consultations requested in the ED were allocated into two groups: consultations requested via the secure messaging application and consultations requested by telephone as verbal. Results: A total of 439 consultations requested in the ED were assessed for eligibility and 345 were included in the final analysis: 173 consultations were conducted using secure messaging application and 172 consultations were conducted using standard telephone communications. The median ED LOS was 240 minutes (IQR:230-270, 95% CI:240 to 255.2) for patients in the secure messaging application group and 277 minutes (IQR:270-287.8, 95% CI:277 to 279) for patients in the telephone group. The median total ED LOS was significantly lower among consults conducted using Secure messaging application relative to consults conducted by telephone (median dif: -30, 95%CI:–37to-25, p<0.0001). The median consult time was 158 minutes (IQR:133 to 177.25, 95% CI:150 to 169) for patients in the Secure messaging application group and 170 minutes (IQR:165 to 188.5, 95% CI:170-171) for patients in the Telephone group (median dif: –12, 95%CI:-19 to-7,p<0.0001). Consultations completed without ED arrival was 61.8% in the secure messaging group and 33.1% in the Telephone group (dif: 28.7, 95% CI:48.3 to 66, p<0.001). Conclusions: Use of secure messaging application for consultations in the ED reduces the total ED LOS and consultation time. Consultation with secure messaging application eliminated more than half of in-person ED consultation visits.Gulacti U, Lok U. Comparison of secure messaging application (WhatsApp) and standard telephone usage for consultations on Length of Stay in the ED. Appl Clin Inform 2017; 8: 742–753 https://doi.org/10.4338/ACI-2017-04-RA-0064

Style APA, Harvard, Vancouver, ISO itp.

34

Botelho, Michael. "The communal consultation: video-recorded student consultations". Medical Education 50, nr 5 (13.04.2016): 573–74. http://dx.doi.org/10.1111/medu.13047.

Pełny tekst źródła

Style APA, Harvard, Vancouver, ISO itp.

35

Jones, Matthew T., Rameez Arif i Ashok Rai. "Patient Experiences With Telemedicine in a National Health Service Rheumatology Outpatient Department During Coronavirus Disease-19". Journal of Patient Experience 8 (styczeń 2021): 237437352110349. http://dx.doi.org/10.1177/23743735211034973.

Pełny tekst źródła

Streszczenie:

The coronavirus disease-19 pandemic changed rheumatology practice with remote consultations being increasingly utilized where appropriate. We evaluated patient experiences with telephone consultations and report on patient attitudes toward current health care delivery and perspectives of telemedicine in a UK National Health Service rheumatology outpatient department. We analyzed 297 questionnaires from a postal survey conducted during the summer of 2020 after a telephone follow-up consultation. The mean age of respondents was 67 years and 68% were female. The 161 respondents (54%) reported it was their first telephone consultation and overall, 239 (84%) were satisfied with their health assessment. 60% would be happy to have future routine follow-up telephone consultations. Patients advised to shield shared similar satisfaction to the whole sample. However, with increasing age we identified a higher proportion were dissatisfied with telephone consultations and unlikely to have accessibility to video consultation or preferentially opt for this modality.

Style APA, Harvard, Vancouver, ISO itp.

36

Beyers, Jan, i Sarah Arras. "Who feeds information to regulators? Stakeholder diversity in European Union regulatory agency consultations". Journal of Public Policy 40, nr 4 (28.05.2019): 573–98. http://dx.doi.org/10.1017/s0143814x19000126.

Pełny tekst źródła

Streszczenie:

AbstractTo design regulatory policies, agencies depend on information from the industries they are tasked to regulate. Therefore, agencies can organise consultations with the aim of obtaining information from different perspectives. This article focuses on stakeholder diversity in agency public consultations. We ask to what extent is information provided by stakeholders other than the regulated sector, such as other business interests, experts or nonbusiness interests? Stakeholder diversity is relevant as it may prevent agencies to become exposed to one-sided information and capture by specialised interests. Are there consultation design factors that foster consultation diversity? Or, is (a lack of) consultation diversity structurally shaped by the context in which an agency operates? Analysing a wide range of public consultations organised by European Union regulatory agencies indicates that most information agencies receive via consultations comes from regulated interests and that the limited participation of nonregulated interests is highly tenacious.

Style APA, Harvard, Vancouver, ISO itp.

37

Støme, Linn Nathalie, Tone Vaksvik, Christian Ringnes Wilhelmsen i Kari Jorunn Kværner. "PP03 Early Assessment Of Video Consultations In Rehabilitation After Hand Injury". International Journal of Technology Assessment in Health Care 38, S1 (grudzień 2022): S39. http://dx.doi.org/10.1017/s0266462322001489.

Pełny tekst źródła

Streszczenie:

IntroductionWith the aim of reducing patient travel and related costs, physiotherapists and occupational therapists at the Oslo University Hospital began offering video consultations to patients with hand and arm injuries in March 2020. A feasibility study was initiated to describe the first year of using video consultations in the rehabilitation of upper extremity injuries in children and adults, and to assess the acceptability of the service from the perspective of hand therapists. The secondary objective of the study was to investigate the economic effects of using video consultation for this patient group.MethodsThe therapists documented the individual consultations in an Excel spreadsheet. Utility and acceptability were analyzed based on the content of each video consultation. The therapists also registered the patient’s municipality in order to calculate costs related to travel, accommodation, and other costs related to in-person consultation. Utility was analyzed using an early economic model based on scenario analysis to compare the costs of video consultations with in-person consultations.ResultsBased on the content analysis from 89 consultations, video consultations were deemed acceptable by the therapists. The total travel distance from patients’ homes to the hospital was 20,190 km, as hand rehabilitation is a national service. The video consultations that replaced the consultations at the hospital were potentially more time efficient, reduced patients’ travel time and absence from home and work, and saved costs for the Oslo University Hospital and society.ConclusionsBased on early decision support provided by this study, adaptions were made to the delivery of video consultations to improve the cost effectiveness of the service. The findings from this study provided an indication of the potential value of the new service, which may be used for benchmarking purposes to ensure that it meets the needs of users, the health service, and society.

Style APA, Harvard, Vancouver, ISO itp.

38

Pecina, Jennifer L., i Frederick North. "A retrospective analysis of medical record use in e-consultations". Journal of Telemedicine and Telecare 23, nr 5 (14.06.2016): 544–49. http://dx.doi.org/10.1177/1357633x16654607.

Pełny tekst źródła

Streszczenie:

Introduction Under certain circumstances, e-consultations can substitute for a face-to-face consultation. A basic requirement for a successful e-consultation is that the e-consultant has access to important medical history and exam findings along with laboratory and imaging results. Knowing just what information the specialist needs to complete an e-consultation is a major challenge. This paper examines differences between specialties in their need for past information from laboratory, imaging and clinical notes. Methods This is a retrospective study of patients who had an internal e-consultation performed at an academic medical centre. We reviewed a random sample of e-consultations that occurred in the first half of 2013 for the indication for the e-consultation and whether the e-consultant reviewed data in the medical record that was older than one year to perform the e-consultation. Results Out of 3008 total e-consultations we reviewed 360 (12%) randomly selected e-consultations from 12 specialties. Questions on management (35.8%), image results (27.2%) and laboratory results (25%) were the three most common indications for e-consultation. E-consultants reviewed medical records in existence more than one year prior to the e-consultation 146 (40.6%) of the time with e-consultants in the specialties of endocrinology, haematology and rheumatology, reviewing records older than one year more than half the time. Labs (20.3%), office notes (20%) and imaging (17.8%) were the types of medical data older than one year that were reviewed the most frequently overall. Discussion Management questions appear to be the most common reason for e-consultation. E-consultants frequently reviewed historical medical data that is older than one year at the time of the e-consultation, especially in endocrinology, haematology and rheumatology specialties. Practices engaging in e-consultations that require transfer of data may want to include longer time frames of historical information for those specialties.

Style APA, Harvard, Vancouver, ISO itp.

39

Edwards, Hannah B., Elsa Marques, William Hollingworth, Jeremy Horwood, Michelle Farr, Elly Bernard, Chris Salisbury i Kate Northstone. "Use of a primary care online consultation system, by whom, when and why: evaluation of a pilot observational study in 36 general practices in South West England". BMJ Open 7, nr 11 (listopad 2017): e016901. http://dx.doi.org/10.1136/bmjopen-2017-016901.

Pełny tekst źródła

Streszczenie:

ObjectivesEvaluation of a pilot study of an online consultation system in primary care. We describe who used the system, when and why, and the National Health Service costs associated with its use.Design15-month observational study.SettingPrimary care practices in South West England.Results36 General practices covering 396 828 patients took part in the pilot. The online consultation website was viewed 35 981 times over the pilot period (mean 9.11 visits per 1000 patients per month). 7472 patients went on to complete an ‘e-consultation’ (mean 2.00 online consultations per 1000 patients per month). E-consultations were mainly performed on weekdays and during normal working hours. Patient records (n=485) were abstracted for eight practices and showed that women were more likely to use e-consultations than men (64.7% vs 35.3%) and users had a median age of 39 years (IQR 30–50). The most common reason for an e-consultation was an administrative request (eg, test results, letters and repeat prescriptions (22.5%)) followed by infections/immunological issues (14.4%). The majority of patients (65.2%) received a response within 2 days. The most common outcome was a face-to-face (38%) or telephone consultation (32%). The former were more often needed for patients consulting about new conditions (OR 1.56, 95% CI 1.05 to 2.27, p=0.049). The average cost of a practice’s response to an e-consultation was £36.28, primarily triage time and resulting face-to-face/telephone consultations needed.ConclusionsUse of e-consultations is very low, particularly at weekends. Unless this can be improved, any impact on staff workload and patient waiting times is likely to be negligible. It is possible that use of e-consultations increases primary care workload and costs. Online consultation systems could be developed to improve efficiency both for staff and patients. These findings have implications for software developers as well as primary care services and policy-makers who are considering investing in online consultation systems.

Style APA, Harvard, Vancouver, ISO itp.

40

Kachman, Marika, Keme Carter, Vineet M. Arora, Andre Flores, David O. Meltzer i Shannon K. Martin. "Describing Variability of Inpatient Consultation Practices: Physician, Patient, and Admission Factors". Journal of Hospital Medicine, Volume 15, Issue 03 (19.02.2020): 164–68. http://dx.doi.org/10.12788/jhm.3355.

Pełny tekst źródła

Streszczenie:

Appropriate use of consultation can improve patient outcomes, but inappropriate use may cause harm. Factors affecting the variability of inpatient consultation are poorly understood. We aimed to describe physician-, patient-, and admission-level factors influencing the variability of inpatient consultations on general medicine services. We conducted a retrospective study of patients hospitalized from 2011 to 2016 and enrolled in the University of Chicago Hospitalist Project, which included 6,153 admissions of 4,772 patients under 69 attendings. Consultation use varied widely; a 5.7-fold difference existed between the lowest (mean, 0.613) and highest (mean, 3.47) quartiles of use (P <.01). In mixed-effect Poisson regression, consultations decreased over time, with 45% fewer consultations for admissions in 2015 than in 2011 (P <.01). Patients on nonteaching hospitalist teams received 9% more consultations than did those on teaching services (P =.02). Significant variability exists in inpatient consultation use. Further understanding may help to identify groups at high-risk for underuse/overuse and aid in the development of interventions to improve high-value care.

Style APA, Harvard, Vancouver, ISO itp.

41

Hiscock, Harriet, Rachel Pelly, Xinjang Hua, Sue West, Dianne Tucker, Chin-Mae Raymundo i Kim Dalziel. "Survey of paediatric telehealth benefits from the caregiver perspective". Australian Health Review 46, nr 2 (18.10.2021): 197–203. http://dx.doi.org/10.1071/ah21036.

Pełny tekst źródła

Streszczenie:

Objective This study determined caregivers’ evaluations of telehealth consultations for their child, preference over in-person consultations and potential cost savings by child condition, family socioeconomic status and location. Methods A survey was conducted of 2436 caregivers attending a telehealth consultation with their child for a broad group of conditions between 3 June and 25 August 2020 at a tertiary paediatric hospital in Melbourne, Australia. Results Most caregivers found telehealth consultations convenient, acceptable, safe and private, and capable of answering their questions and concerns. However, caregivers who spoke a language other than English and patients attending for behavioural and mental health, developmental or other (e.g. allied health) concerns were more likely to prefer in-person consultations over telehealth. Mean (±s.d.) reported cost savings on caregiver time were A$144.98 ± 99.04 per family per consultation, whereas mean (±s.d.) transport cost savings were A$84.90 ± 100.74 per family per consultation. Cost savings were greatest for families living in low and middle socioeconomic areas and regional or rural areas. Conclusions Paediatric telehealth video consultations were largely viewed favourably by caregivers, except for those attending for behavioural and mental health or developmental concerns. What is known about the topic? Adult consumers of telehealth consultations view them as useful, convenient and cost saving, but less is known about caregivers’ evaluations of telehealth consultations and potential cost savings for paediatric patients, and whether these differ by family location, socioeconomic status or child condition. What does this paper add? This is the first Australian paper to report on caregivers’ evaluations across a range of paediatric conditions and locations. Most caregivers found telehealth consultations convenient, safe, acceptable, able to answer their questions and concerns about their child’s health and cost saving. What are the implications for practitioners? Caregivers of children with behavioural, mental health or developmental problems were less likely to prefer telehealth over in-person consultations, so practitioners should consider providing such consultations in person.

Style APA, Harvard, Vancouver, ISO itp.

42

Bezet, Amanda, Taylor Duncan i Kira Litvin. "Implementation and evaluation of online, synchronous research consultations for graduate students". Library Hi Tech News 35, nr 6 (6.08.2018): 4–8. http://dx.doi.org/10.1108/lhtn-09-2017-0070.

Pełny tekst źródła

Streszczenie:

Purpose Librarians at Northcentral University (NCU) provide online synchronous research consultations for students to discuss resources and search strategies for class assignments, papers, presentations, theses and dissertations. The purpose of this paper is to document the implementation and assessment of this service and to seek to demonstrate that research consultations provided by NCU librarians contribute to students’ learning and success. Design/methodology/approach Research consultations are scheduled using Springshare LibCal and are conducted via Citrix GoToMeeting. Students report their satisfaction and skills learned via the Research Consultation Satisfaction Survey. Dissertation chairs and faculty instructors complete separate surveys, which assess the effect that research consultations had on their students’ work. All surveys were created using Qualtrics. Findings Assessment data reveal that students are satisfied with the research consultation service and can identify specific skills learned. Additionally, faculty and dissertation chairs report an improvement in students’ citations and ability to locate relevant sources. Future research may include examination of learning analytics or citation analysis for students who participated in research consultations. Originality/value Research consultations are rarely documented in the scholarly literature. An opportunity exists to make virtual research consultations more widely adopted as a distinct library reference service, and further, to measure the impact of this service. This project demonstrates how to successfully implement and assess online research consultations. Techniques discussed may be used in 100 per cent virtual environments, as well as within traditional, brick and mortar schools that may already offer face-to-face research consultations.

Style APA, Harvard, Vancouver, ISO itp.

43

Zhou, Fengli, Zhouhan Wang, Xiaojun Mai, Xiaoyun Liu, Christopher Reid, Sally Sandover, Kouxing Zhang i Dan Xu. "Online Clinical Consultation as a Utility Tool for Managing Medical Crisis During a Pandemic: Retrospective Analysis on the Characteristics of Online Clinical Consultations During the COVID-19 Pandemic". Journal of Primary Care & Community Health 11 (styczeń 2020): 215013272097551. http://dx.doi.org/10.1177/2150132720975517.

Pełny tekst źródła

Streszczenie:

Coronavirus disease 2019 (COVID-19) is a newly-identified infectious diseases that has rapidly spread throughout the world with rising fatalities with declaration by World Health Organization as the pandemic. Online consultations have been shown to alleviate the pandemic with our study aims to demonstrate whether online consultation can be a solution for acute health crisis. Retrospective analysis of the characteristics of online consultations through two primary care online-consultation platforms during COVID-19 pandemic was performed at the Third Affiliated Hospital of Sun Yat-Sen University, which led the assessment of COVID-19-symptoms patients in Guangzhou. The 3473 online consultations were divided into pre-pandemic and pandemic period groups with Chi-square test as statistical analysis method. The number of online consultations has increased with diagnosis of upper respiratory tract infection, psychological conditions, COVID-19-related investigations and interventions. The increased online consultations met the increased demand of the relevant clinical services and reduced the overwhelming hospital presentations, thus decreasing the potential COVID-19 spread inside the major tertiary hospital and sparing the resources for acute crisis management. The epidemiology and disease characteristics of online consultations during the pandemic have been demonstrated with identification of the enabling factors and potential barriers in improving online healthcare in China with online consultation model being a durable solution for pandemic in future.

Style APA, Harvard, Vancouver, ISO itp.

44

Assing Hvidt, Elisabeth, Anette Grønning, Elle Lüchau, Maja Nordtug, Martin Bavngaard i Jens Søndergaard. "Video Consultations in General Practice: Tendencies and Lessons Learned From the First COVID-19 Lockdown Period". Iproceedings 8, nr 1 (23.08.2022): e41530. http://dx.doi.org/10.2196/41530.

Pełny tekst źródła

Streszczenie:

Background Video consultation was urgently introduced in general practice in connection with the COVID-19 pandemic, where a rapid implementation ensured patients’ continued access to their general practitioner (GP). With the Danish lockdown in March 2020, the use of video consultations in general practice increased drastically and then declined significantly shortly after as society gradually reopened. Today, only a small proportion of the total number of consultations in general practice is made up of video consultations, and there is great variation in the scope and use of video consultation among GPs and practice staff. Objective The aim of this paper is to present research findings from a qualitative, interdisciplinary project, investigating GP and patient experiences with video consultations during the first lockdown period in 2020, which might help explain the abovementioned tendencies in relation to scope and implementation variances. Methods The data corpus includes data generated through semistructured interviews with 27 patients and 15 GPs, as well as 8 video recordings of video consultations between GP and patient. Results The patients reported positive experiences with consulting their GP through video, valuing increased convenience and spatial flexibility and wishing for future use of video consultation as either a supplement or an alternative to physical consultation. Video consultation furthermore presented a new communicative context in which both patients and GPs enacted distinct forms of technologically facilitated participation. Conclusions To further the best use of video consultation in future general practice, organizational and individual factors such as renumeration, task delegation, time pressure, and professional identity need to be considered.

Style APA, Harvard, Vancouver, ISO itp.

45

Vestesson, Emma Maria, Kaat Lieve An De Corte, Elizabeth Crellin, Jean Ledger, Minal Bakhai i Geraldine M. Clarke. "Consultation Rate and Mode by Deprivation in English General Practice From 2018 to 2022: Population-Based Study". JMIR Public Health and Surveillance 9 (2.05.2023): e44944. http://dx.doi.org/10.2196/44944.

Pełny tekst źródła

Streszczenie:

Background The COVID-19 pandemic has had a significant impact on primary care service delivery with an increased use of remote consultations. With general practice delivering record numbers of appointments and rising concerns around access, funding, and staffing in the UK National Health Service, we assessed contemporary trends in consultation rate and modes (ie, face-to-face versus remote). Objective This paper describes trends in consultation rates in general practice in England for key demographics before and during the COVID-19 pandemic. We explore the use of remote and face-to-face consultations with regard to socioeconomic deprivation to understand the possible effect of changes in consultation modes on health inequalities. Methods We did a retrospective analysis of 9,429,919 consultations by general practitioners, nurses, or other health care professionals between March 2018 and February 2022 for patients registered at 397 general practices in England. We used routine electronic health records from Clinical Practice Research Datalink Aurum with linkage to national data sets. Negative binomial models were used to predict consultation rates and modes (ie, remote versus face-to-face) by age, sex, and socioeconomic deprivation over time. Results Overall consultation rates increased by 15% from 4.92 in 2018-2019 to 5.66 in 2021-2022 with some fluctuation during the start of the COVID-19 pandemic. The breakdown into face-to-face and remote consultations shows that the pandemic precipitated a rapid increase in remote consultations across all groups, but the extent varies by age. Consultation rates increased with increasing levels of deprivation. Socioeconomic differences in consultation rates, adjusted for sex and age, halved during the pandemic (from 0.36 to 0.18, indicating more consultations in the most deprived), effectively narrowing relative differences between deprivation quintiles. This trend remains when stratified by sex, but the difference across deprivation quintiles is smaller for men. The most deprived saw a relatively larger increase in remote and decrease in face-to-face consultation rates compared to the least deprived. Conclusions The substantial increases in consultation rates observed in this study imply an increased pressure on general practice. The narrowing of consultation rates between deprivation quintiles is cause for concern, given ample evidence that health needs are greater in more deprived areas.

Style APA, Harvard, Vancouver, ISO itp.

46

Houwen, Juul, Peter LBJ Lucassen, Hugo W. Stappers, Willem JJ Assendelft, Sandra van Dulmen i Tim C. olde Hartman. "Improving GP communication in consultations on medically unexplained symptoms: a qualitative interview study with patients in primary care". British Journal of General Practice 67, nr 663 (28.08.2017): e716-e723. http://dx.doi.org/10.3399/bjgp17x692537.

Pełny tekst źródła

Streszczenie:

BackgroundMany GPs find the care of patients with medically unexplained symptoms (MUS) challenging. Patients themselves are often not satisfied with the care they receive.AimTo explore the problems patients with MUS experience in communication during consultations, with the aim of improving such consultationsDesign and settingA qualitative analysis of semi-structured interviews.MethodGP consultations were videorecorded and the GPs were asked immediately afterwards whether MUS were presented. Patients in these MUS consultations were asked to reflect on the consultation in a semi-structured interview while watching a recording of their own consultation.ResultsOf the 393 videorecorded consultations, 43 contained MUS. Patients who did identified six categories of problems. First, they reported a mismatch between the GP’s and their own agenda. Second, patients indicated that the GP evoked an uncomfortable feeling in them during the consultation. Third, they found that GPs did not provide a specific management plan for their symptoms. Fourth, patients indicated that the GP was not well prepared for the consultation. Fifth, they perceived prejudices in the GP during the consultation. Finally, one patient found that the GP did not acknowledge a limited understanding of the origin of the symptoms.ConclusionAccording to patients, GPs can improve their consultations on MUS by making genuine contact with their patients, by paying more attention to the patient’s agenda, and by avoiding evoking uncomfortable feelings and displaying prejudices. They should prepare their consultations and focus on the issues that matter to patients, for example, symptom management. GPs should be honest to patients when they do not understand the origin of symptoms.

Style APA, Harvard, Vancouver, ISO itp.

47

Bauer, Brenton S., Ai Len Nguyen-Phan, Michael K. Ong, Boback Ziaeian i Kim-Lien Nguyen. "Cardiology electronic consultations: Efficient and safe, but consultant satisfaction is equivocal". Journal of Telemedicine and Telecare 26, nr 6 (25.02.2019): 341–48. http://dx.doi.org/10.1177/1357633x19828130.

Pełny tekst źródła

Streszczenie:

Background Cardiovascular electronic consultation is a new service line in consultative medicine and enables care without in-person office visits. We aimed to evaluate accessibility and time saved as measures of efficiency, determine the safety of cardiology electronic consultations, and assess satisfaction by responding cardiologists. Methods Using a mixed-methods approach and a modified time-driven, activity-based, costing framework, we retrospectively analysed cardiology electronic consultations. A random subset of 500 electronic consultations referred between 2013–2017 were reviewed. Accessibility was determined based upon increased number of patients served without the need for an in-person clinic visit. To assess safety, medical records were reviewed for emergency room visits or hospital admission at six months from the initial electronic consultation date. Responding cardiologist satisfaction was assessed by voluntary completion of an online survey. Results The majority of electronic consultations were related to medication advice, clearance for surgery, evaluation of images, or guidance after abnormal testing. Recommendations included echo (10.8%), stress testing (5.0%), other imaging (4.0%) and other subspecialist referrals (3.8%). Electronic consultations were completed within 0.7±0.5 days of the request, with a time to completion of 5–30 min. Over a six-month follow-up, 13.9% of patients had an in-person visit and 2.2% of patients were hospitalised, but none were directly related to the electronic consultation question. Satisfaction by responding cardiologists was modest. Conclusion In conclusion, within a single-payer system, cardiology electronic consultations represent a convenient and safe alternative for providing consultative cardiovascular care, but further optimization is necessary to minimise electronic consultation fatigue experienced by cardiologists.

Style APA, Harvard, Vancouver, ISO itp.

48

Kurtser, M. A., R. I. Shalina, D. S. Spiridonov, I. I. Kurtsikidze, A. G. Smirnova i A. A. Belkina. "Telemedicine Consultations in Obstetrics and Gynecology". Doctor.Ru 22, nr 1 (2023): 7–10. http://dx.doi.org/10.31550/1727-2378-2023-22-1-7-10.

Pełny tekst źródła

Streszczenie:

Aim: To study the possibilities of using telemedicine consultations in the work of an obstetrician-gynecologist. Design: Retrospective case series. Materials and methods. An analysis of 319 doctor — patient telemedicine consultations conducted by obstetricians-gynecologists of the MD Medical Group “Mother and Child” was carried out. Each consultation was characterized by 7 parameters: the format of communication, the relevance of the topic of the question to the profile of “obstetrics and gynecology”, the motivation to consult with a doctor remotely, the patient's complaints, the type of the follow-up medical care required and its urgency, the possibility to complete the consultation without a mandatory visit to a face-to-face appointment. Results. 313 (98.1%) consultations had the subject of obstetrics, gynecology or reproduction. Most often (210; 61.7%) patients wanted to receive a preliminary consultation to determine the need for face-to-face visit to the doctor. The most common issues for consultation (100; 31.9%) were topics related to the management of pregnancy. The vast majority of requests (296; 94.6%) did not require an emergency call for an ambulance or an urgent visit to a doctor. In 148 (47.3%) consultations, the consultant's qualification allowed answering all questions, but despite this, according to the Russian Federation legislation, it was recommended to consult a doctor face-to-face. Conclusion. With a systematic approach to the introduction of telemedicine consultations, their effectiveness may not be lower compared to the effectiveness of similar traditional visits with comparable safety and significant savings in resources for both the patient and the healthcare system as a whole. Keywords: telemedicine, telemedicine consultations.

Style APA, Harvard, Vancouver, ISO itp.

49

Billington, Emma O., A. Lynn Feasel, Jessica L. VanDyke i Gregory A. Kline. "Group medical consultation for osteoporosis: a prospective pilot study of patient experience in Canadian tertiary care". British Journal of General Practice 70, nr 700 (5.10.2020): e801-e808. http://dx.doi.org/10.3399/bjgp20x713081.

Pełny tekst źródła

Streszczenie:

BackgroundDelivery of patient-centred care is limited by physician time. Group medical consultations may save physician time without compromising patient experience.AimTo assess patient experience and specialist physician time commitment in a group consultation for osteoporosis.Design and settingProspective pilot study at a tertiary osteoporosis centre in Canada between May 2016 and June 2019.MethodThe authors evaluated women referred for osteoporosis who chose a 2-hour group consultation instead of a one-to-one consultation. Group consultations were led by an osteoporosis nurse and specialist physician, and consisted of individualised fracture risk assessment and education regarding osteoporosis therapies, followed by a decision-making exercise to choose a treatment plan. Patients then followed up with their GPs to implement this plan. Patient experience was assessed via a questionnaire immediately and 3 months post-consultation, at which time GP satisfaction and patient treatment status were also surveyed.ResultsOf 560 referrals received, 18 patients declined osteoporosis specialist assessment, 54 could not be contacted, 303 attended a one-to- one consultation, and 185 attended a group consultation. Mean participant age was 62.8 years (standard deviation [SD] 5.8) and the Fracture Risk Assessment Tool (FRAX) 10-year osteoporotic fracture risk was 13.0 (SD 7.0)%. Immediately post-consultation, 104 (97.2%) patients were satisfied and 102 (95.3%) felt included in decision making. Satisfaction was reported by 95/99 (96.0%) patients and 27/36 (75.0%) GPs. Treatment plans had been enacted by 90 (90.1%) patients. For a matched number of individual consultations, each group session conferred a specialist physician time savings of 5.5 hours.ConclusionGroup consultations represent a satisfactory and time-efficient alternative to one-to-one consultations for select patients with osteoporosis.

Style APA, Harvard, Vancouver, ISO itp.

50

Woods, Robert A., Renee Lee, Maria B. Ospina, Sandra Blitz, Harris Lari, Michael J. Bullard i Brian H. Rowe. "Consultation outcomes in the emergency department: exploring rates and complexity". CJEM 10, nr 01 (styczeń 2008): 25–31. http://dx.doi.org/10.1017/s1481803500009970.

Pełny tekst źródła

Streszczenie:

ABSTRACTObjective:Consultation is a common and important aspect of emergency department (ED) care. We prospectively examined the consultation rates, the admission rates of consulted patients, the emergency physician (EP) disposition prediction of consulted patients and the difficult consultations rates in 2 tertiary care hospitals.Methods:Attending EPs recorded consultations during 5 randomly selected shifts over an 8-week period using standardized forms. Subsequent computer outcome data were extracted for each patient encounter, as well as demographic data from the ED during days in which there was a study shift.Results:During 105 clinical shifts, 1930 patients were managed by 21 EPs (median 17 patients per shift; interquartile range 14–23). Overall, at least 1 consultation was requested in 38% of patients. More than one-half of the patients (54.3%) who received a consultation were admitted to the hospital. Consultation proportions were similar between males and females (51% v. 49%,p= 0.03). Consultations occurred more frequently for patients who were older, had higher acuity presentations, arrived during daytime hours or arrived by ambulance. The proportion of agreement between the EP's and consultant's opinion on the need for admission was 89% (κ = 0.77, 95% confidence interval 0.72–0.83). Overall, 92% of patents received 1 consultation. Six percent of the consultations were perceived as “difficult” by the EPs (defined as the EP's subjective impression of difficulties with consultation times, accessibility and availability of consultants, and the interaction with consultants or disposition issues).Conclusion:Consultation is a common process in the ED. It often results in admission and is predictable based on simple patient factors. Because of perceived difficulty with consultations, strategies to improve the EP consultation process in the ED seem warranted.

Style APA, Harvard, Vancouver, ISO itp.

Artykuły w czasopismach na temat „Consultations”

Utwórz poprawne odniesienie w stylach APA, MLA, Chicago, Harvard i wielu innych