E-Consultation in Headache Medicine: A Quality Improvement Pilot Study.
Cross-Sectional Studies
Feasibility Studies
Headache Disorders
/ diagnosis
Health Care Surveys
/ statistics & numerical data
Humans
Migraine Disorders
/ diagnosis
Pilot Projects
Prospective Studies
Quality Improvement
/ standards
Referral and Consultation
/ standards
Retrospective Studies
Telemedicine
/ standards
Triage
/ standards
e-consultation
headache
quality improvement
referral
telemedicine
triage
Journal
Headache
ISSN: 1526-4610
Titre abrégé: Headache
Pays: United States
ID NLM: 2985091R
Informations de publication
Date de publication:
Nov 2020
Nov 2020
Historique:
received:
11
11
2019
revised:
02
09
2020
accepted:
03
09
2020
pubmed:
17
10
2020
medline:
12
11
2021
entrez:
16
10
2020
Statut:
ppublish
Résumé
Access to headache consultations by a headache specialist is limited. E-consultations are an efficient approach shown to reduce costs and improve continuity of care with the primary care provider. Indications, suitability, and uptake in the headache population are not well studied. This quality improvement pilot aims to explore the appropriateness of e-consultations for patients referred to a headache specialist. E-consultation feasibility was explored through (1) retrospective review of completed face-to-face consultations; (2) prospective survey of providers to identify face-to-face consultations appropriate for e-consultation; (3) cross-sectional review of the current waiting list to assess theoretical triaging to face-to-face vs e-consultation; and (4) prospective review of all e-consultations requested from an academic headache clinic to improve the understanding of e-consultation feasibility and referral triage. The retrospective review included 75 face-to-face consultations with a mean (SD) wait time of 33 (39.4) days for consultations, of which 28/75 (37.3%) were deemed to be feasible e-consultations. The prospective survey of providers identified 10 face-to-face consultations that were felt to be theoretically appropriate for e-consultation. The cross-sectional review identified 20 patients on the clinic waiting list, of whom 5/20 (25%) were theoretically triaged to e-consultation. Finally, the prospective review found 12 requested e-consultations, of which 6/12 (50%) were for migraine prophylaxis recommendations. Chart data often lacked details for complete assessments, with 5/12 (41.7%) converted to face-to-face consultations and only 4/12 (33.3%) deemed appropriate for e-consultation. E-consultation in headache medicine could be considered if appropriately triaged. Pathways are needed to reach patients earlier in their disease course to ensure headache care meets guideline recommendations, and e-consultation is 1 option. However, better communication with primary care is required for system optimization.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2192-2201Informations de copyright
© 2020 American Headache Society.
Références
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