Highlights
- •e-Health strategies can improve the performance of health systems.
- •Medical teleconsultation is a component of the e-Health strategies.
- •Medical teleconsultation to general practitioners supports internal medicine case solving.
- •Medical teleconsultation reduces the medical error vulnerability of the patient.
- •Medical teleconsultation on a large scale may be supportive to the health system.
Abstract
Background
e-Health strategies are supposed to improve the performance of national health systems.
Medical teleconsultation (MT) is an important component of such e-Health strategies.
Objectives
The outcome of MT was evaluated with regard to the impact on the medical error vulnerability
(MEV) of internal medicine patients.
Methods
A team of internal medicine doctors plus a network of forty specialists was set-up
in one health district belonging to a unified and universal national health system
of a country of Western Europe, in order to provide free-of-charge MT to support general
practitioners in solving internal medicine cases. In this observational study, the
case series of 2013 is reviewed.
Results
a) Only 21% of the MT fell short to the general practitioner's expectations about
the case solving focus; b) throughout the medical care process of the patient, 49%
of the cases met with one or more of the five MEVs, namely: 1) clinical test mishandling;
2) inaccurate differential diagnosis; 3) inadequate information flow between health
providers at different levels of care (transition care); 4) poor coordination between
health providers; and 5) poor reconciliation of medications or hazardous therapies.
c) MT canceled or prevented MEVs in 56% and mitigate MEVs in 15% of the cases; d)
MT canceled or prevented 85% of MEV caused by poor information exchange in transition
care, therefore improving patient referral and counter-referral.
Conclusions
MT reduces MEV and therefore, whenever implemented to a large extent, may improve
the quality of health care delivery and the performance of national health systems.
Abbreviations:
GP (General practitioner), ICT (Information and communication technologies), MEV (Medical error vulnerability), MT (Medical teleconsultation), WHO (World Health Organization), ITU (International Technology Unit)Keywords
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Article info
Publication history
Published online: August 29, 2015
Accepted:
August 14,
2015
Received in revised form:
August 11,
2015
Received:
July 23,
2015
Identification
Copyright
© 2015 European Federation of Internal Medicine. Published by Elsevier Inc. All rights reserved.
