Abstract:
OBJECTIVE:Health information technology (HIT) holds promise in increasing access to rheumatologists by improving the quality and efficiency of referrals, but few studies have examined its use for this purpose. We evaluated the use and impact of a novel electronic referral (eReferral) system in rheumatology in a safety-net health system. METHODS:We examined eReferrals over 4 years. Our primary outcome was use of preconsultation exchange, defined as back-and-forth communication between referring and specialty care providers, facilitating triage of referrals, requests for more information, or resolution of questions without a visit. We calculated the proportion of eReferrals that underwent preconsultation exchange, time to reviewer response, and number of visits scheduled. To increase generalizability, we selected a random sample of eReferrals to undergo additional blinded, adjudicated review to assess agreement on appropriateness for preconsultation exchange. RESULTS:Between 2008 and 2012, 2,383 eReferrals were reviewed and 2,105 were eligible for analysis. One-fourth of eReferrals were resolved without a clinic visit. The proportion of eReferrals undergoing preconsultation exchange increased over time (55% in 2008 versus 74% in 2011), and the volume of referrals also steadily increased over time. Reviewer response time averaged between 1 and 4 days. In the random sample of eReferrals that underwent adjudicated review, agreement between reviewers was high (κ = 0.72). CONCLUSION:HIT-enabled preconsultation exchange was used for a majority of eReferrals and facilitated communication between referring clinicians and rheumatologists. This redesigned system of care allowed for triage of a high number of referrals, with many referrals determined to be appropriate for preconsultation exchange.
journal_name
Arthritis Care Res (Hoboken)journal_title
Arthritis care & researchauthors
Scheibe MM,Imboden JB,Schmajuk G,Margaretten M,Graf JD,Chen AH,Yelin EH,Yazdany Jdoi
10.1002/acr.22559subject
Has Abstractpub_date
2015-08-01 00:00:00pages
1158-63issue
8eissn
2151-464Xissn
2151-4658journal_volume
67pub_type
杂志文章abstract:OBJECTIVE:To evaluate pain, fatigue, and psychological functioning of childhood-onset systemic lupus erythematosus (SLE) patients and examine how these factors impact health-related quality of life (HRQOL). METHODS:At a tertiary rheumatology clinic, 60 childhood-onset SLE patients completed the following: a visual ana...
journal_title:Arthritis care & research
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journal_title:Arthritis care & research
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journal_title:Arthritis care & research
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journal_title:Arthritis care & research
pub_type: 临床试验,杂志文章,随机对照试验
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journal_title:Arthritis care & research
pub_type: 杂志文章
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更新日期:2015-03-01 00:00:00
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更新日期:2017-08-01 00:00:00
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journal_title:Arthritis care & research
pub_type: 杂志文章
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更新日期:2012-06-01 00:00:00
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更新日期:2017-04-01 00:00:00
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更新日期:2010-03-01 00:00:00
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journal_title:Arthritis care & research
pub_type: 杂志文章
doi:10.1002/acr.21820
更新日期:2013-02-01 00:00:00
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journal_title:Arthritis care & research
pub_type: 杂志文章,多中心研究
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更新日期:2015-12-01 00:00:00
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更新日期:2016-05-01 00:00:00
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journal_title:Arthritis care & research
pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2017-10-01 00:00:00
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更新日期:2017-05-01 00:00:00
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pub_type: 杂志文章,多中心研究
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更新日期:2017-08-01 00:00:00
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pub_type: 杂志文章
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更新日期:2012-12-01 00:00:00
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更新日期:2011-02-01 00:00:00
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pub_type: 杂志文章,多中心研究
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更新日期:2015-04-01 00:00:00