Medical teleconsultation to general practitioners reduces the medical error vulnerability of internal medicine patients

Campanella, N; Morosini, Pierpaolo; Sampaolo, G; Catozzo, Vania; Caso, Andrea; Ferretti, Maurizio; Giovagnoli, Moreno; Torniai, Mariangela; Antico, E

doi:10.1016/j.ejim.2015.08.010

Cited by 9 publications

(6 citation statements)

References 17 publications

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“…A second approach is use of telemedicine or teleconsultation to link inexperienced providers with mentors to help navigate buprenorphine OMT procedures. These approaches are becoming more widely used in general medicine (Biery, Bond, Smith, LeClair, & Foster, 2015; Eaton et al, 2015; Gillis, 2015; Khan et al, 2015; Marcolino, Pereira Afonso Dos Santos, Santos Neves, & Alkmim, 2015), have been associated with reductions in medical errors or referrals to formal treatments (Campanella et al, 2015), and have particular value for remote or rural areas (Saurman, Lyle, Perkins, & Roberts, 2014) for which research has indicated there is a dearth of available opioid treatment options (Blum et al, 2016; Cunningham et al, 2007; Jones et al, 2015; Knudsen et al, 2005; Knudsen, 2015). The Physician Clinical Support System-Buprenorphine(PCSS-B) is a federally funded program that is already in place to pair newly waivered physicians with an experienced provider usually via telephone or email, but possibly with in-person meetings as well (Egan et al, 2010).…”

Section: Discussionmentioning

confidence: 99%

Why aren't physicians prescribing more buprenorphine?

Huhn

Dunn

2017

Journal of Substance Abuse Treatment

236

201

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Background & Objective Buprenorphine is an underutilized pharmacotherapy that can play a key role in combating the opioid epidemic. Individuals with opioid use disorder (OUD) often struggle to find physicians that prescribe buprenorphine. Many physicians do not have the waiver to prescribe buprenorphine, and a large proportion of physicians that are waivered do not prescribe to capacity. This study aimed to quantitatively understand why physicians do not utilize buprenorphine for the treatment of OUD more frequently. Methods Physicians (n=558) with and without the waiver to prescribe buprenorphine were surveyed about perceived drawbacks associated with prescribing buprenorphine. Furthermore, resources were identified that would encourage those without the waiver to obtain it, and those with the waiver to accept more new patients. The survey was distributed online to physicians in the spring/summer of 2016 via the American Society for Addiction Medicine and American Medical Association Listervs. Results and Conclusions A logistic regression analysis was used to identify reasons that respondents indicated no willingness to increase prescribing (2(4) = 73.18, p < .001); main reasons were lack of belief in agonist treatment (or 3.98, 95% CI, 1.43 to 11.1, p = .008), lack of time for additional patients (or 5.54, 95% CI, 3.5 to 8.7, p < .001), and belief that reimbursement rates are insufficient (or 2.50, 95% CI, 1.3 to 4.8, p = .006). Differences between non-waivered and waivered physicians concerning attitudes toward buprenorphine treatment as well as resources that would increase willingness to prescribe are also discussed. Identifying barriers to buprenorphine utilization is crucial in expanding treatment options for individuals with OUD.

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Section: Discussionmentioning

confidence: 99%

Why aren't physicians prescribing more buprenorphine?

Huhn

Dunn

2017

Journal of Substance Abuse Treatment

236

201

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“…In recent years, the considerable mobile-cellular infrastructure has been leveraged to mitigate some of these challenges in health service delivery, for instance, by facilitating task shifting of health service delivery from facility-based providers to frontline health workers. 3 In these task-shifting applications, mobile devices have been used to provide training content on-demand, enable communication between different cadres of health workers, implement clinical decision support systems, and provide work-planning and scheduling tools. There is growing evidence that such ‘digital health’ strategies can help improve access to and quality of health service delivery, which, in turn, can improve health outcomes for otherwise underserved populations.…”

Section: Introductionmentioning

confidence: 99%

Strengthening Delivery of Health Services Using Digital Devices

Orton

Agarwal

Muhoza

et al. 2018

Glob Health Sci Pract

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Delivery of high-quality efficient health services is a cornerstone of the global agenda to achieve universal health coverage. Digital health interventions for service delivery, such as digital health-enhanced referral coordination and mobile clinical decision support systems, demonstrate considerable potential to improve the quality and comprehensiveness of care received by patients but require greater standardization and engagement of health workers at different levels of the health system for effective scale up.

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“…96 97 Telemedicine services permitting e-consultations between primary care providers and specialists have additionally been found to reduce vulnerability to medical error among internal medicine patients. 98 However, limitations and potential pitfalls of teleneurology must also be considered. Some have raised concerns that replacing face-to-face interactions with virtual interactions may occasion an erosion of the doctor–patient relationship, with potential downstream effects on trust, empathy, and adherence.…”

Section: Beneficence Nonmaleficence and The Therapeutic Relationship In Teleneurology Settingsmentioning

confidence: 99%

Neuroethics in the Era of Teleneurology

Young

2022

Semin Neurol

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The accelerating integration of telehealth technologies in neurology practice has transformed traditional interactions between neurologists and patients, allied clinicians and society. Despite the immense promise of these technologies to improve systems of neurological care, the infusion of telehealth technologies into neurology practice introduces a host of unique ethical challenges. Proactive consideration of the ethical dimensions of teleneurology and of the impact of these innovations on the field of neurology more generally can help to ensure responsible development and deployment across stages of implementation. Toward these ends, this article explores key ethical dimensions of teleneurology practice and policy, presents a normative framework for their consideration, and calls attention to underexplored questions ripe for further study at this evolving nexus of teleneurology and neuroethics. To promote successful and ethically resilient development of teleneurology across diverse contexts, clinicians, organizational leaders, and information technology specialists should work closely with neuroethicists with the common goal of identifying and rigorously assessing the trajectories and potential limits of teleneurology systems.

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Medical teleconsultation to general practitioners reduces the medical error vulnerability of internal medicine patients

Cited by 9 publications

References 17 publications

Why aren't physicians prescribing more buprenorphine?

Why aren't physicians prescribing more buprenorphine?

Strengthening Delivery of Health Services Using Digital Devices

Neuroethics in the Era of Teleneurology

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