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Medical teleconsultation to general practitioners reduces the medical error vulnerability of internal medicine patients

Published:August 29, 2015DOI:https://doi.org/10.1016/j.ejim.2015.08.010

      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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