Semergen · 2026
[Results of a pilot project of e-consultation from primary care to a movement disorders unit in a tertiary hospital].
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Lorenzo-Barreto P, Muro I, Casas E, Sánchez-Pobre Berejano P, Cobos-Pozo P, Vivancos-Mora J, López-Manzanares L
Аннотация
OBJECTIVE: Telemedicine has the potential to improve access to specialized care. This study aimed to evaluate the appropriate use of a direct virtual consultation between Primary Care (PC) and a Movement Disorders Unit (MDU). Secondary objectives included assessing diagnostic agreement, the utilization of complementary tests, care timelines, and estimating the environmental impact.
MATERIAL AND METHODS: A retrospective descriptive study was conducted on virtual consultations initiated by PC centers affiliated with our tertiary hospital between June 2023 and April 2024. Demographic, clinical, healthcare-related and environmental data were collected.
RESULTS: A total of 196 virtual consultations were analyzed. Of these, 3.2% did not fully meet referral criteria. The median time between consultation initiation and telematic response by the MDU was 1day (IQR: 1-1; maximum 3days). Subsequent face-to-face assessment was required in 85.7% of cases, with a median of 13days to appointment (IQR: 3-23). Complementary tests were requested in 49.5% of cases. In patients with suspected Parkinsonism, moderate diagnostic agreement between PC and MDU was observed (kappa index: 0.60; P<.001). A total savings of 29kg of CO2 was estimated by avoiding intermediate consultations.
CONCLUSIONS: This pilot project of a direct e-consultation model between PC and the MDU demonstrated appropriate use and enabled characterization of care pathways, diagnostic agreement, and care timelines. The findings suggest a potential organizational and environmental impact that should be confirmed in future comparative studies.
MATERIAL AND METHODS: A retrospective descriptive study was conducted on virtual consultations initiated by PC centers affiliated with our tertiary hospital between June 2023 and April 2024. Demographic, clinical, healthcare-related and environmental data were collected.
RESULTS: A total of 196 virtual consultations were analyzed. Of these, 3.2% did not fully meet referral criteria. The median time between consultation initiation and telematic response by the MDU was 1day (IQR: 1-1; maximum 3days). Subsequent face-to-face assessment was required in 85.7% of cases, with a median of 13days to appointment (IQR: 3-23). Complementary tests were requested in 49.5% of cases. In patients with suspected Parkinsonism, moderate diagnostic agreement between PC and MDU was observed (kappa index: 0.60; P<.001). A total savings of 29kg of CO2 was estimated by avoiding intermediate consultations.
CONCLUSIONS: This pilot project of a direct e-consultation model between PC and the MDU demonstrated appropriate use and enabled characterization of care pathways, diagnostic agreement, and care timelines. The findings suggest a potential organizational and environmental impact that should be confirmed in future comparative studies.