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; Rodríguez-López, Marina; Melero-González, Rafael Benito; Rodríguez-Fernández, José Benito

doi:10.1186/s12913-021-07455-4

Cited by 9 publications

(2 citation statements)

References 41 publications

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“…Implementation of e-consultation programmes may significantly reduce wait times while assuring prioritization of inflammatory diseases and improving communication between healthcare levels. 27 Another promising strategy is self-referral. Recent data have shown that an online self-referral tool can be used in specialized centres in addition to a physician-based referral strategy to improve early diagnosis and to increase awareness of axSpA, especially in people younger than 40 years old.…”

Section: Diagnosismentioning

confidence: 99%

A glance into the future of diagnosis and treatment of spondyloarthritis

Navarro-Compán¹,

Ermann

Poddubnyy

2022

Therapeutic Advances in Musculoskeletal

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The last two decades have seen major developments in the field of spondyloarthritis (SpA), but there are still important unmet needs to address. In the future, we envisage important advances in the diagnosis and treatment of SpA. In the diagnosis of SpA, the use of online and social media tools will increase awareness of the disease and facilitate the referral of patients to rheumatology clinics. In addition, more specific diagnostic tests will be available, especially advanced imaging methods and new biomarkers. This will allow most patients to be diagnosed at an early stage of the disease. In the treatment of SpA, an increasing number of novel treatment targets can be expected, most of which will be directed against intracellular enzymes. We hope to see more strategy trials shaping treatment pathways in SpA and accommodating principals of precision medicine. Approved treatment options will be available for both axial and peripheral SpA. We also hope to intervene not only at the inflammation level but also at the level of underlying immunological processes that might be associated with a higher probability of long-standing remission if not a cure. Finally, artificial intelligence techniques will allow for the analysis of large-scale data to answer relevant research questions for the diagnosis and management of patients with SpA.

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Section: Diagnosismentioning

confidence: 99%

A glance into the future of diagnosis and treatment of spondyloarthritis

Navarro-Compán¹,

Ermann

Poddubnyy

2022

Therapeutic Advances in Musculoskeletal

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“…Background: EPISER study has confirmed the great burden of rheumatic diseases, which represent almost 30% of primary care medical consultations in Spain [1,2]. Electronic consultation could be an alternative response [3] as well as rheumatologist-led update programmes and joint case discussion with primary care physicians have shown to reduce the burden of care and waiting times in rheumatology units [4]. Objectives: To analyze the demand from primary care to the rheumatology service of a tertiary hospital.…”

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confidence: 99%

Ab1833-Hpr study of the Demand for Referrals From Primary Care to the Rheumatology Department of a Tertiary Hospital

De la Torre Rubio,

Pavía Pascual,

Campos

et al. 2023

Health Professionals in Rheumatology Abstracts

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BackgroundEPISER study has confirmed the great burden of rheumatic diseases, which represent almost 30% of primary care medical consultations in Spain[1,2]. Electronic consultation could be an alternative response[3]as well as rheumatologist-led update programmes and joint case discussion with primary care physicians have shown to reduce the burden of care and waiting times in rheumatology units[4].ObjectivesTo analyze the demand from primary care to the rheumatology service of a tertiary hospital.MethodsRetrospective descriptive study of the data consecutively collected from 15 to 30 May 2022 from new rheumatology consultations at the reference hospital requested from primary care (PC) health centers in the area. The following variables were collected: waiting time (median and range in days), referral route (ordinary, preferential or e-consultation), reason for derivation, type of visit (discharge or follow-up), suspicion of inflammatory disease by the specialist in Family and Community Medicine (Yes/No), confirmation diagnosis of inflammatory disease by the specialist in Rheumatology (Yes/No), time from onset of inflammatory symptoms to rheumatology consultation (median and range in months), referral with analytical tests (Yes/No/With acute phase reactants) and with musculoskeletal image requested by the PC physician (Yes/No); those provided by patients in private centers were excluded. Descriptive statistics were used for the presentation of results and Cohen’s Kappa coefficient was calculated to quantify the degree of agreement in the diagnosis of inflammatory disease between primary care physicians and rheumatologists.ResultsA total of 116 new consultations were registered in the system referring to 100 patients, 16 did not attend their appointment. Results are shown inTable 1. The degree of agreement according to Cohen’s Kappa index was 0.53, representing 80% of agreement (moderate degree). No differences were found between health care centers in the referral rate according to the population assisted by each health care center.ConclusionMain reasons for consultation were ‘osteoporosis assessment’ and ‘polyarthralgias’. Ordinary route was the most frequently used with a median waiting time of 80 days and 50 days for preferential route. Thirty percent of patients were referred with analysis and 75% with some musculoskeletal image. The degree of agreement was moderate in the diagnosis of inflammatory disease between primary care physicians and rheumatologists.References[1] Carmona L et al. The burden of musculoskeletal diseases in the general population of Spain: results from a national survey. Ann Rheum Dis 2001 -11;60(11):1040-1045.[2] Seoane-Mato D et al. Frequency of medical visits due to osteoarticular problems of the adult general population in Spain. EPISER2016 Study. Gac Sanit 2020 Sep - Oct;34(5):514-517.[3] Pego-Reigosa JM et al. Analysis of the implementation of an innovative IT solution to improve waiting times, communication with primary care and efficiency in Rheumatology. BMC Health Serv Res 2022 -01-12;22(1):60.[4] Surís X et al. A rheumatology consultancy program with general practitioners in Catalonia, Spain. J Rheumatol. 2007 Jun;34(6):1328-31.Table 1.Description of variablesWaiting time in days (median (range))OrdinaryPreferentiale-consultation79 (159)50 (150)35 (58)Referral route (%)OrdinaryPreferentiale-consultation73234Reason for derivation (%)OsteoporosisPolyarthralgiaArthrosisRheumatoid arthritisSpondyloarthritisFibromyalgiaGoutLow back painPolymyalgia rheumaticaPsoriatic arthritisRaynaud’s phenomenonOther221798854432119Type of visit (%)DsichargeFollow-up1882Suspicion of inflammatory disease by the specialist in Family and Community Medicine (%)38Confirmation diagnosis of inflammatory disease by the specialist in Rheumatology (%)20Time from onset of inflammatory symptoms to Rheumatology consultation in months (median (range))13 (44)Additional tests (%)Analysis (with PCR and VSG)Musculoskeletal image3175Acknowledgements:NIL.Disclosure of InterestsNone Declared.

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