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Analysis of the implementation of an innovative IT solution to improve waiting times, communication with primary care and efficiency in Rheumatology
OBJECTIVE: To describe in detail an innovative program based on telemedicine for semi-automated prioritization of referrals from Primary Care (PC) to Rheumatology, for reproducibility purposes, and to present the results of the implementation study. METHODS: The context and situation were carefully...
Autores principales: | , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8754366/ https://www.ncbi.nlm.nih.gov/pubmed/35022061 http://dx.doi.org/10.1186/s12913-021-07455-4 |
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author | Pego-Reigosa, José María Peña-Gil, Carlos Rodríguez-Lorenzo, David Altabás-González, Irene Pérez-Gómez, Naír Guzmán-Castro, John Henry Varela-Gestoso, Rodrigo Díaz-Lambarri, Reyes González-Carreró-López, Alberto Míguez-Senra, Olga Bóveda-Fontán, Julia Charle-Crespo, Ángeles Caramés-Casal, Francisco Javier Barbazán-Álvarez, Ceferino Hernández-Rodríguez, Íñigo Maceiras-Pan, Francisco Rodríguez-López, Marina Melero-González, Rafael Rodríguez-Fernández, José Benito |
author_facet | Pego-Reigosa, José María Peña-Gil, Carlos Rodríguez-Lorenzo, David Altabás-González, Irene Pérez-Gómez, Naír Guzmán-Castro, John Henry Varela-Gestoso, Rodrigo Díaz-Lambarri, Reyes González-Carreró-López, Alberto Míguez-Senra, Olga Bóveda-Fontán, Julia Charle-Crespo, Ángeles Caramés-Casal, Francisco Javier Barbazán-Álvarez, Ceferino Hernández-Rodríguez, Íñigo Maceiras-Pan, Francisco Rodríguez-López, Marina Melero-González, Rafael Rodríguez-Fernández, José Benito |
author_sort | Pego-Reigosa, José María |
collection | PubMed |
description | OBJECTIVE: To describe in detail an innovative program based on telemedicine for semi-automated prioritization of referrals from Primary Care (PC) to Rheumatology, for reproducibility purposes, and to present the results of the implementation study. METHODS: The context and situation were carefully analyzed, paying attention to all processes in place, referral numbers, waiting times, and number of complementary tests prior to discharge from Rheumatology. The composition of the team, aims, users, scope, and implementation phases were defined. Eight process indicators were established and measured before and 32 months after the program implementation. RESULTS: The program, which includes IT circuits, algorithms based on response to specific guideline-based checklists, e-consultation, and appointments based on priority, was fully implemented in our health area after a pilot study in two PC centers. After implementation, 6185 rheumatology referrals showed an e-consultation response delay of 8.95 days, and to first face-to-face visit (after e-consultation) of 12.6 (previous delay before program implementation was 83.1 days). Resolution by e-consultation reached 20% (1195 patients did not need seeing the rheumatologist to have the problem solved), and 1369 patients (32%) were discharged after the first visit. The overall resolution rate was 44.0% (2564 discharges/5830 e-consultations). From a random sample of 100 visits, only 10% of patients needed additional complementary tests to make a diagnosis and decision by Rheumatology (20.9% decrease from previous period). CONCLUSION: A careful analysis of the situation and processes, with implementation of simple IT circuits, allows for the improvement of the efficiency and resolution of problems in Rheumatology. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-021-07455-4. |
format | Online Article Text |
id | pubmed-8754366 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-87543662022-01-13 Analysis of the implementation of an innovative IT solution to improve waiting times, communication with primary care and efficiency in Rheumatology Pego-Reigosa, José María Peña-Gil, Carlos Rodríguez-Lorenzo, David Altabás-González, Irene Pérez-Gómez, Naír Guzmán-Castro, John Henry Varela-Gestoso, Rodrigo Díaz-Lambarri, Reyes González-Carreró-López, Alberto Míguez-Senra, Olga Bóveda-Fontán, Julia Charle-Crespo, Ángeles Caramés-Casal, Francisco Javier Barbazán-Álvarez, Ceferino Hernández-Rodríguez, Íñigo Maceiras-Pan, Francisco Rodríguez-López, Marina Melero-González, Rafael Rodríguez-Fernández, José Benito BMC Health Serv Res Research OBJECTIVE: To describe in detail an innovative program based on telemedicine for semi-automated prioritization of referrals from Primary Care (PC) to Rheumatology, for reproducibility purposes, and to present the results of the implementation study. METHODS: The context and situation were carefully analyzed, paying attention to all processes in place, referral numbers, waiting times, and number of complementary tests prior to discharge from Rheumatology. The composition of the team, aims, users, scope, and implementation phases were defined. Eight process indicators were established and measured before and 32 months after the program implementation. RESULTS: The program, which includes IT circuits, algorithms based on response to specific guideline-based checklists, e-consultation, and appointments based on priority, was fully implemented in our health area after a pilot study in two PC centers. After implementation, 6185 rheumatology referrals showed an e-consultation response delay of 8.95 days, and to first face-to-face visit (after e-consultation) of 12.6 (previous delay before program implementation was 83.1 days). Resolution by e-consultation reached 20% (1195 patients did not need seeing the rheumatologist to have the problem solved), and 1369 patients (32%) were discharged after the first visit. The overall resolution rate was 44.0% (2564 discharges/5830 e-consultations). From a random sample of 100 visits, only 10% of patients needed additional complementary tests to make a diagnosis and decision by Rheumatology (20.9% decrease from previous period). CONCLUSION: A careful analysis of the situation and processes, with implementation of simple IT circuits, allows for the improvement of the efficiency and resolution of problems in Rheumatology. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-021-07455-4. BioMed Central 2022-01-12 /pmc/articles/PMC8754366/ /pubmed/35022061 http://dx.doi.org/10.1186/s12913-021-07455-4 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Pego-Reigosa, José María Peña-Gil, Carlos Rodríguez-Lorenzo, David Altabás-González, Irene Pérez-Gómez, Naír Guzmán-Castro, John Henry Varela-Gestoso, Rodrigo Díaz-Lambarri, Reyes González-Carreró-López, Alberto Míguez-Senra, Olga Bóveda-Fontán, Julia Charle-Crespo, Ángeles Caramés-Casal, Francisco Javier Barbazán-Álvarez, Ceferino Hernández-Rodríguez, Íñigo Maceiras-Pan, Francisco Rodríguez-López, Marina Melero-González, Rafael Rodríguez-Fernández, José Benito Analysis of the implementation of an innovative IT solution to improve waiting times, communication with primary care and efficiency in Rheumatology |
title | Analysis of the implementation of an innovative IT solution to improve waiting times, communication with primary care and efficiency in Rheumatology |
title_full | Analysis of the implementation of an innovative IT solution to improve waiting times, communication with primary care and efficiency in Rheumatology |
title_fullStr | Analysis of the implementation of an innovative IT solution to improve waiting times, communication with primary care and efficiency in Rheumatology |
title_full_unstemmed | Analysis of the implementation of an innovative IT solution to improve waiting times, communication with primary care and efficiency in Rheumatology |
title_short | Analysis of the implementation of an innovative IT solution to improve waiting times, communication with primary care and efficiency in Rheumatology |
title_sort | analysis of the implementation of an innovative it solution to improve waiting times, communication with primary care and efficiency in rheumatology |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8754366/ https://www.ncbi.nlm.nih.gov/pubmed/35022061 http://dx.doi.org/10.1186/s12913-021-07455-4 |
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