WHAT IS KNOWN ABOUT THE TOPIC?
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The integration of electronic medical records among health care levels allows professionals at different care levels to share access to patients’ clinical information, improves communication, and enables the possible development of new clinical management modalities for outpatient care that optimize health care resources. This approach crystallizes the integration among levels by avoiding fragmentation of care and promotes coordination, continuity of care, and integrated patient management.1
The ASISC provides health care coverage to 446 603 people; 352 331 are older than 14 years. This population is characterized by its considerable geographical dispersion, which involves 46 local governments. In total, 107 812 people are older than 65 years; they represent 24.2% of the regional population. To provide health care to the population older than 14 years, the health care area is equipped with 301 PC physicians, who perform their duties in 56 health care centers and 21 peripheral
A total of 47 377 patients were attended in the study period (38.1% under the one-time consultation model and 61.9% under the e-consultation model). Of those attended via e-consultation, 21.4% did not require a face-to-face consultation, 30.4% required 1 face-to-face consultation, and 48.2% required 2 or more face-to-face consultations (figure 2).
The characteristics of the patients attended by care model are shown in table 1. There were no differences in age or sex between the 2 models.
Here, we describe the results of a universal e-consultation program in a cardiology service for referrals made by PC physicians. The clinical characteristics of the patients were similar in the 2 outpatient care models (table 1). Our data show that the implementation of an e-consultation program in the outpatient care model effectively reduces waiting times and is safe, with a significant reduction in emergency department attendance, hospital admissions, and mortality. In addition, the model
An outpatient care program in a cardiology service that includes e-consultation improves access to health care and thereby reduces waiting times for specialized care. This model is safe and is associated with lower rates of emergency department attendance, hospital admission, and mortality in the first year vs a one-time face-to-face care program. We believe that our experience could help in the design of outpatient care management programs that improve health care access and patient prognosis.WHAT IS KNOWN ABOUT THE TOPIC?
The authors report no conflicts of interest in relation to this article.
We thank Dr Francisco Gude Sampedro of the Clinical Epidemiology Unit of the Health Research Institute of Santiago de Compostela (IDIS) for advice and help with the statistical analysis and manuscript drafting.