The Utilization of an Electronic Consultation Service During the Coronavirus Disease 2019 Pandemic.

Jatinderpreet Singh, Erin Keely, Sheena Guglani, Gary Garber, Clare Liddy
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引用次数: 6

Abstract

Objective: The coronavirus disease 2019 (COVID-19) pandemic forced many clinicians to rapidly adopt changes in their practice. In this study, we compared patterns of utilization of Ontario eConsult before and after the onset of the COVID-19 pandemic, to assess COVID 19's impact on how eConsult is used. Materials and Methods: We conducted a longitudinal analysis of registration and utilization data for Ontario eConsult. All primary care providers (PCPs) and specialists who joined the service between March 2019 and November 2020, and all eConsult cases closed during the same period were included. The data were divided into two timeframes for comparison: prepandemic (March 2019-February 2020) and pandemic (March 2020-November 2020). Results: In total, 5,925 PCPs joined during the study period, more than doubling total enrollment to 11,397. The average monthly number of eConsults increased from 2,405 (standard deviation [SD] = 260) prepandemic to 3,906 (SD = 420) pandemic. Case volume jumped to 24.3% in the first month of the pandemic, and increased by 71% during the COVID-19 pandemic timeframe. The median response time was similar in both timeframes (prepandemic: 1.0 days; pandemic: 0.9 days). The proportion of cases resulting in new/additional information (prepandemic: 55%, pandemic: 57%) or avoidance of a contemplated referral (prepandemic: 52%, pandemic: 51%) remained consistent between timeframes. Conclusions: Registration to and usage of eConsult increased during the pandemic. Metrics of the service's impact, including response time, percentage of cases resulting in new or additional information, and avoidance of originally contemplated referrals were all consistent between the prepandemic and COVID-19 pandemic timeframes, suggesting scalability.

2019冠状病毒病大流行期间电子会诊服务的利用
目的:2019冠状病毒病(COVID-19)大流行迫使许多临床医生迅速改变其实践。在本研究中,我们比较了2019冠状病毒病大流行前后安大略省eConsult的使用模式,以评估2019冠状病毒病对eConsult使用方式的影响。材料和方法:我们对安大略省eConsult的登记和使用数据进行了纵向分析。所有在2019年3月至2020年11月期间加入该服务的初级保健提供者(pcp)和专家,以及同期结案的所有eConsult病例都被纳入其中。数据分为两个时间框架进行比较:大流行前(2019年3月至2020年2月)和大流行(2020年3月至2020年11月)。结果:在研究期间,共有5,925名pcp加入,总入组人数增加了一倍多,达到11,397人。每月平均econsult数从大流行前的2405例(标准差[SD] = 260)增加到大流行前的3906例(SD = 420)。在大流行的第一个月,病例量跃升至24.3%,在COVID-19大流行期间增加了71%。这两个时间框架的中位反应时间相似(大流行前:1.0天;大流行:0.9天)。导致获得新的/额外信息的病例比例(大流行前:55%,大流行前:57%)或避免考虑转诊(大流行前:52%,大流行前:51%)在不同时间框架之间保持一致。结论:大流行期间eConsult的注册和使用有所增加。服务影响的指标,包括响应时间、导致新信息或额外信息的病例百分比,以及避免最初设想的转诊,在大流行前和COVID-19大流行的时间框架之间都是一致的,这表明了可扩展性。
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