Cost and Potential Savings of Electronic Consultation and Its Relationship with Reduction in Atmospheric Pollution

Aldana, D. Rey; Santías, Francisco Reyes; Ramos, Pilar Mazón; Romero, Manuel Portela; Cinza‐Sanjurjo, Sergio; Álvarez, Belén Álvarez; Bermejo, Rosa Agra; Gude‐Sampedro, Francisco; González-Juanàtey, José Ramón

doi:10.3390/su132212436

Cited by 8 publications

(6 citation statements)

References 30 publications

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“…Te implementation of this model reduced signifcantly the mean waiting time. Although there are previous experiences in other medical specialties, to the best of our knowledge, this is the frst time an e-consultation model is applied to pulmonology [22][23][24][25][26][27]. In total, 43.5% of cases were solved via e-consultation, slightly exceeding our estimates, and in an intermediate range with respect to previous studies (range: 21.4-69%) [6,22,23].…”

Section: Discussioncontrasting

confidence: 64%

“…Our results suggest that e-consultations prevent unnecessary actions, foster the management of health problems at the appropriate level of healthcare, and possibly reduce costs by avoiding unnecessary medical procedures, complementary studies, and travel [ 21 , 24 , 25 ]. This contributes to ensuring the sustainability of the healthcare system.…”

Section: Discussionmentioning

confidence: 99%

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Cost-Effectiveness of a New Outpatient Pulmonology Care Model Based on Physician-to-Physician Electronic Consultation

Álvarez-Dobaño

Toubes

Novo-Platas³

et al. 2022

Canadian Respiratory Journal

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Introduction. This study assesses the impact of an electronic physician-to-physician consultation program on the waiting list and the costs of a Pulmonology Unit. Materials and Methods. A prepost intervention study was conducted after a new ambulatory pulmonary care protocol was implemented and the capacity of the unit was adopted. In the new model, physicians at all levels of healthcare send electronic consultations to specialists. Results. In the preintervention year (2019), the Unit of Pulmonology attended 7,055 consultations (466 e-consultations and 6,589 first face-to-face visits), which decreased to 6,157 (3,934 e-consultations and 2,223 first face-to-face visits; 12.7% reduction) in the postintervention year (all were e-consultations). The mean wait time for the first appointment was 25.7 days in 2019 versus 3.2 days in 2021 ( p < 0.001 ). In total, 43.5% of cases were solved via physician-to-physiciane-consultation. A total of 2,223 patients needed a face-to-face visit, with a mean wait time of 7.5 days. The mean of patients in the waiting listing decreased from 450.8 in 2019 to 44.8 in 2021 (90% reduction). The annual time devoted to e-consultations and first face-to-face visits following an e-consultation diminished significantly after the intervention (1,724 hours versus 2,312.8; 25.4% reduction). Each query solved via e-consultation represented a saving of €652.8, resulting in a total annual saving of €827,062. Conclusions. Physician-to-physiciane-consultations reduce waiting times, improve access of complex patients to specialty care, and ensure that cases are managed at the appropriate level. E-consultation reduces costs, which benefits both, society and the healthcare system.

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Section: Discussioncontrasting

confidence: 64%

Section: Discussionmentioning

confidence: 99%

Cost-Effectiveness of a New Outpatient Pulmonology Care Model Based on Physician-to-Physician Electronic Consultation

Álvarez-Dobaño

Toubes

Novo-Platas³

et al. 2022

Canadian Respiratory Journal

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“…*Odds ratios adjusted in a multivariate analysis including age, gender, co-morbidities, number of emergency department visits, time until the e-consultation is answered, type of consultation they were referred to (see Table 2). programme could reduce the in-person healthcare burden, avoid unnecessary patient and caregiver's vehicle journeys, 14 and improve the management of patients with this disease, which is prevalent and frequently decompensates. 15 Thus, this decision would directly affect the actual organization of the outpatient HF care programmes.…”

Section: Discussionmentioning

confidence: 99%

“…We think that all HF patients whose GP has referred to a CD must be evaluated by a cardiologist in a short period of time, and that this assessment can be made using telemedicine (in our case, via e‐consultation). Apart from improving their prognosis, this programme could reduce the in‐person healthcare burden, avoid unnecessary patient and caregiver's vehicle journeys, 14 and improve the management of patients with this disease, which is prevalent and frequently decompensates 15 . Thus, this decision would directly affect the actual organization of the outpatient HF care programmes.…”

Section: Discussionmentioning

confidence: 99%

An electronic consultation program impacts on heart failure patients' prognosis: implications for heart failure care

et al. 2022

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Aims e-consults are asynchronous, clinician-to-clinician exchanges that answer focused, non-urgent, patient-specific questions using the electronic medical record. We instituted an e-consultation programme (2013)(2014)(2015)(2016)(2017)(2018)(2019) for all general practitioners (GPs) referrals to cardiologists that preceded patients' in-person consultations when considered. In our study, we aimed to analyse the clinical characteristics, 1 year prognosis and the prognostic determinants of patients with a previous diagnosis of HF referred for an e-consult, categorized by their previous HF-related hospitalization status (recent hospitalization, <1 year before; remote hospitalization, >1 year before or never been hospitalized because of HF), and to analyse the impact of reducing the time elapsed between e-consultation and response by the cardiologist in terms of prognosis. Methods and resultsEpidemiological and clinical data were obtained from 4851 HF patients referred by GPs to the cardiology department for an e-consultation 2013 and 2020. The delay of time to e-consults were solved was 8.6 + 8.6 days with 84.3% solved in <14 days. For the 1 year prognosis evaluation after the e-consult were assessed the cardiovascular hospitalizations, HF-related hospitalizations, HF-related mortality, cardiovascular mortality, and all-cause mortality. Compared with the group without a previous hospitalization, patients with recent and remote HF hospitalization were at higher risk of a new HF-related hospitalization (

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“…We have recently published that the inclusion of an e‐consultation via our integrated electronic health record at the start of outpatient assistance can reduce delay times for care, visits to the emergency service, hospital admissions and mortality rates 4,14 . In addition, it helps to reduce the direct and indirect costs for the patient and the healthcare system 15 …”

Section: Introductionmentioning

confidence: 99%

Gender differences on healthcare accessibility and outcomes of a electronic inter‐clinician consultation program at the cardiology department in a Galician Health Area

Mazón‐Ramos

Aldana

Garcia‐Vega

et al. 2023

Eur J Clin Investigation

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AimsTo assess the longer‐term results (hospital admissions and mortality) in women versus men referred to a cardiology department from primary care using an e‐consultation in our outpatient care programme.MethodsWe selected 61,306 patients (30,312 women and 30,994 men) who visited the cardiology service at least once between 2010 and 2021: 69.1% (19,997 women and 20,462 men) were attended in e‐consultation (from 2013 to 2021) and 30.9% (8920 women and 9136 men) in in‐person consultations (from 2010 to 2012) without gender differences in the proportion of patients attended in each period. Using an interrupted time series regression model, we analysed the impact of incorporating e‐consultation into the healthcare model and evaluated the elapsed time to cardiology care, heart failure (HF), cardiovascular (CV), and all‐cause hospital admissions and mortality during the one‐year after cardiology consultation.ResultsThe introduction of e‐consultation substantially decreased waiting times to cardiology care; during the in‐person consultation period, the mean delay for cardiology care was 57.9 (24.8) days in men and 55.8 (22.8) days in women. During the e‐consultation period, the waiting time to cardiology care was markedly reduced to 9.41 (4.02) days in men and 9.46 (4.18) in women. After e‐consultation implantation, there was a significant reduction in the 1‐year rate of hospital admissions and mortality, both in women and men iRR [IC 95%]: 0.95 [0.93–0.96] for HF, 0.90 [0.89–0.91] for CV and 0.70 [0.69–0.71] for all‐cause hospitalization; and 0.93 [0.92–0.95] for HF, 0.86 [0.86–0.87] for CV and 0.88 [0.87–0.89] for all‐cause mortality in women; and 0.91 [0.89–0.92] for HF, 0.90 [0.89–0.91] for CV and 0.72 [0.71–0.73] for all‐cause hospitalization; and 0.96 [0.93–0.97] for HF, 0.87 [95% CI: 0.86–0.87] for CV and 0.87 [0.86–0.87] for all‐cause mortality, in men.ConclusionCompared with the in‐person consultation period, an outpatient care programme that includes an e‐consultation significantly reduced waiting time to cardiology care and was safe, with a lower rate of hospital admissions and mortality in the first year, without significative gender differences.

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Cost and Potential Savings of Electronic Consultation and Its Relationship with Reduction in Atmospheric Pollution

Cited by 8 publications

References 30 publications

Cost-Effectiveness of a New Outpatient Pulmonology Care Model Based on Physician-to-Physician Electronic Consultation

Cost-Effectiveness of a New Outpatient Pulmonology Care Model Based on Physician-to-Physician Electronic Consultation

An electronic consultation program impacts on heart failure patients' prognosis: implications for heart failure care

Gender differences on healthcare accessibility and outcomes of a electronic inter‐clinician consultation program at the cardiology department in a Galician Health Area

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