How Accurate Are First Visit Diagnoses Using Synchronous Video Visits with Physicians?

Ohta, Mitsuyasu; Ohira, Yoshiyuki; Uehara, Takanori; Keira, Kazunori; Noda, Kazutaka; Hirukawa, Misa; Shikino, Kiyoshi; Kajiwara, Hideki; Shimada, Fumio; Hirota, Yoshikazu; Ikegami, Akiko; Ikusaka, Masatomi

doi:10.1089/tmj.2015.0245

Cited by 18 publications

(15 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…-The diagnosis can be as accurate as face-to-face 45 -Way to overcome distances and provide care without displacing the patient 21,26,28,49 -Resource that meets the patients' requests for additional visits and strengthens supervised self-care 29 , with an effective monitoring of adherence to drug therapy and change of habits, minimizing the risks of treatment interruption 26 -It can promote the reorganization of health systems to a patient-centered approach, with the possibility of improving primary care provision 31 -Resource savings 26,28,49 : 70% of patients visiting clinics do not need a consultation 48,50 and absenteeism from work costs the British economy $7 billion in 2015 50 -Useful for some patients 26,32 and their selection depends on the doctor' s experience, the patient' s circumstances and preferences, the capacity of the service and the complexity of the case 49 -Adapts to current time limitations for health care 41…”

Section: Benefitsmentioning

confidence: 99%

“…-Inability to perform the patient' s physical examination 25,26,28 -Patients are less willing to use it with an unknown doctor 51 and the distance can have a negative impact on the doctor-patient relationship 15 -Patient eligibility 29,50 and decreased access for vulnerable patients, especially the elderly 15,41 or those with difficulties in using technological resources 15,21,29,32 -Resistance by professionals 29 and patients 15,29 or, also, difficulty using it 28,29 -Technical challenges can hinder the doctors' work 29,33 -Concerns about data security 26,45,50 and clinical conduct accuracy 26,45,50 -Resource savings evidence is not robust to justify its implementation 42 -Increased workload 32 , structural changes 15 and organizational difficulties to establish new routines and overcome regulatory or political issues 29…”

Section: Limitationsmentioning

confidence: 99%

“…Regarding equity and accessibility, the literature states that teleconsultation is not adequate for all patients or for all situations, which can decrease the access of the most vulnerable individuals, with difficulties to use technology 15,21,29,32 as the elderly 15,41 or children 45 .…”

Section: Teleconsultation Indicationsmentioning

confidence: 99%

“…Another study carried out in Japan compared face-to-face diagnosis to that performed by video on the first visit to a hospital and concluded that video diagnosis can provide the same level of accuracy for adult patients, as long as there are trained technicians to assist in physical examination and electronic equipment, such as stethoscopes and high definition cameras, developed for examining cavities and organs 45 . The resolution does not report the need for the presence of other professionals to assist with physical examination or diagnosis when providing care in remote areas.…”

Section: Doctor-patient Relationshipmentioning

confidence: 99%

See 3 more Smart Citations

Teleconsulta: uma Revisão Integrativa da Interação Médico-Paciente Mediada pela Tecnologia

Catapan

Calvo

2020

Rev. bras. educ. med.

View full text Add to dashboard Cite

Medical teleconsultation can apply different technologies to mediate the communication between doctors and patients located in different geographic spaces. Its implementation has been encouraged in several countries, under the assumption of its potential to overcome distances, offering health care in a shorter time, reducing costs and workload. The scarcity of evidence about these allegations, in addition to the need of clarifying the situations in which teleconsultation can be adequate, safe and effective, have generated debates, intensified after the publication of Resolution N. 2.227/2018 by the Federal Council of Medicine, which allowed medical teleconsultation, containing principles and recommendations. This article aims to analyze the international experience of medical teleconsultation, including the media and technologies employed, their use, benefits and limitations, highlighting and associating the controversial points of the resolution recently published by the Federal Council of Medicine. An integrative review of the literature was carried out to identify these experiences from January 2013 to February 2019. Of the 1912 identified references, 42 were analyzed after applying the exclusion and inclusion criteria. Data collection and analysis indicated that telephone, e-mail, e-consulting systems, video or a combination of those have been used in several countries to mediate the doctor-patient relationship. Its use goes ranges from diagnosis to treatment, monitoring, management and prescription, both in acute and chronic conditions. The main benefits include less demand for face-to-face consultations, with the possibility of doctors’ workload management, allowing systems’ reorganization. Moreover, the teleconsultation allows overcoming distance barriers, in a flexible and convenient way for patients, possibly contributing to continuity of care, patient autonomy and resource savings, in the latter case, when it avoids work absenteeism due to face-to-face consultation. Some limitations of the teleconsultation include the inability to perform the physical examination, so it is not recommended for the first consultation. Technical and communication difficulties for each media, as well as its inadequacy for some groups of patients, are other important barriers. Data security regarding diagnosis and clinical precision, patients’ and professionals’ acceptance and the need for organizational adjustments are also considered limitations of the teleconsultation. The success of the teleconsultation depends on the integration of different organizations and professionals, aiming to maximize its potential and improve service design, encompassing clinical, technical, organizational and context issues. Therefore, it is important to investigate in which contexts, situations and conditions the teleconsultation can be beneficial, safe and effective for patient care, as well as the most appropriate means of communication.

show abstract

Section: Benefitsmentioning

confidence: 99%

Section: Limitationsmentioning

confidence: 99%

Section: Teleconsultation Indicationsmentioning

confidence: 99%

Section: Doctor-patient Relationshipmentioning

confidence: 99%

See 2 more Smart Citations

Teleconsulta: uma Revisão Integrativa da Interação Médico-Paciente Mediada pela Tecnologia

Catapan

Calvo

2020

Rev. bras. educ. med.

View full text Add to dashboard Cite

show abstract

“…• Dans une étude sur le diagnostic auprès d'une cohorte de 97 adultes à leur première visite dans une clinique de médecine générale, les consultations en personne étaient suivies par une vidéoconférence avec un médecin différent 1 des problèmes courants en soins primaires : la pneumonie (6,7 %), l'insuffisance cardiaque (5,7 %), l'insuffisance rénale aiguë (5,3 %) et le cancer (5,3 %) 11 .…”

Section: Données Probantesunclassified

Consultations virtuelles ou en personne en soins primaires

Sept

Kirkwood²,

Korownyk

2020

Can Fam Physician

View full text Add to dashboard Cite

Assessment of Clinician Diagnostic Concordance With Video Telemedicine in the Integrated Multispecialty Practice at Mayo Clinic During the Beginning of COVID-19 Pandemic From March to June 2020

et al. 2022

View full text Add to dashboard Cite

IMPORTANCEThere was a shift in patient volume from in-person to video telemedicine visits during the COVID-19 pandemic. OBJECTIVE To determine the concordance of provisional diagnoses established at a video telemedicine visit with diagnoses established at an in-person visit for patients presenting with a new clinical problem. DESIGN, SETTING, AND PARTICIPANTS This is a diagnostic study of patients who underwent a video telemedicine consultation followed by an in-person outpatient visit for the same clinical problem in the same specialty within a 90-day window. The provisional diagnosis made during the video telemedicine visit was compared with the reference standard diagnosis by 2 blinded, independent medical reviewers. A multivariate logistic regression model was used to determine factors significantly related to diagnostic concordance. The study was conducted at a large academic integrated multispecialty health care institution (Mayo Clinic locations in Rochester, Minnesota; Scottsdale and Phoenix, Arizona; and Jacksonville, Florida; and Mayo Clinic Health System locations in Iowa, Wisconsin, and Minnesota) between March 24 and June 24, 2020. Participants included Mayo Clinic patients residing in the US without age restriction. Data analysis was performed from December 2020 to June 2021. EXPOSURES New clinical problem assessed via video telemedicine visit to home using Zoom Care Anyplace integrated into Epic. MAIN OUTCOMES AND MEASURES Concordance of provisional diagnoses established over video telemedicine visits compared against a reference standard diagnosis. RESULTS There were 2393 participants in the analysis. The median (IQR) age of patients was 53 (37-64) years; 1381 (57.7%) identified as female, and 1012 (42.3%) identified as male. Overall, the provisional diagnosis established over video telemedicine visit was concordant with the in-person reference standard diagnosis in 2080 of 2393 cases (86.9%; 95% CI, 85.6%-88.3%). Diagnostic concordance by International Statistical Classification of Diseases and Related Health Problems, TenthRevision chapter ranged from 64.7% (95% CI, 42.0%-87.4%) for diseases of the ear and mastoid process to 96.8% (95% CI, 94.7%-98.8%) for neoplasms. Diagnostic concordance by medical specialty ranged from 77.3% (95% CI, 64.9%-89.7%) for otorhinolaryngology to 96.0% (92.1%-99.8%) for psychiatry. Specialty care was found to be significantly more likely than primary (continued) Key Points Question How concordant to an in-person diagnosis are provisional diagnoses established at a video telemedicine visit for patients presenting with a new clinical problem? Findings In this diagnostic study of 2393 patients who underwent a video telemedicine consultation followed by an in-person outpatient visit for the same clinical problem in the same specialty within a 90-day window, the provisional diagnosis established over video telemedicine visit matched the in-person reference standard diagnosis in 86.9% of cases. Meaning These findings suggest that video telemedicine visits yield a high deg...

show abstract

How Accurate Are First Visit Diagnoses Using Synchronous Video Visits with Physicians?

Cited by 18 publications

References 13 publications

Teleconsulta: uma Revisão Integrativa da Interação Médico-Paciente Mediada pela Tecnologia

Teleconsulta: uma Revisão Integrativa da Interação Médico-Paciente Mediada pela Tecnologia

Consultations virtuelles ou en personne en soins primaires

Assessment of Clinician Diagnostic Concordance With Video Telemedicine in the Integrated Multispecialty Practice at Mayo Clinic During the Beginning of COVID-19 Pandemic From March to June 2020

Contact Info

Product

Resources

About