Evidence map›Paper›PMID 30377145›Full record

ArticleJMIR medical informatics2018

Benefits and Costs of Digital Consulting in Clinics Serving Young People With Long-Term Conditions: Mixed-Methods Approach.

Sung Wook Kim, Jason Madan, Melina Dritsaki, Carol Bryce, Vera Forjaz, Joe Fraser, Frances Griffiths, Kathryn Hamilton, Caroline Huxley, Jackie Sturt

Open access · goldAbstract read
In one paragraph

Article in JMIR medical informatics, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.7field-weighted citation impact, top 22% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 5 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 4 institutions in 1 country.

Sung Wook KimDivision of Health Sciences, Warwick Medical School, The University of Warwick, Coventry, United Kingdom.ORCID http://orcid.org/0000-0002-1254-5038
Jason MadanDivision of Health Sciences, Warwick Medical School, The University of Warwick, Coventry, United Kingdom.ORCID http://orcid.org/0000-0003-4316-1480
Melina DritsakiOxford Clinical Trials Research Unit, Botnar Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom.ORCID http://orcid.org/0000-0002-1673-3036
Carol BryceDivision of Health Sciences, Warwick Medical School, The University of Warwick, Coventry, United Kingdom.ORCID http://orcid.org/0000-0003-1484-9032
Vera ForjazDepartment of Clinical, Educational and Health Psychology, University College London, London, United Kingdom.ORCID http://orcid.org/0000-0001-8754-5289
Joe FraserJoe's Diabetes Ltd, Coventry, United Kingdom.ORCID http://orcid.org/0000-0003-0899-9296
Frances GriffithsDivision of Health Sciences, Warwick Medical School, The University of Warwick, Coventry, United Kingdom.ORCID http://orcid.org/0000-0002-4173-1438
Kathryn HamiltonDepartment of Clinical, Educational and Health Psychology, University College London, London, United Kingdom.ORCID http://orcid.org/0000-0002-2147-4702
Caroline HuxleyDivision of Health Sciences, Warwick Medical School, The University of Warwick, Coventry, United Kingdom.ORCID http://orcid.org/0000-0001-9755-6096
Jackie SturtDepartment of Clinical, Educational and Health Psychology, University College London, London, United Kingdom.ORCID http://orcid.org/0000-0003-1281-1401
University of Warwick · GBUniversity College London · GBCoventry (United Kingdom) · GBNuffield Orthopaedic Centre · GB

Funding

Department of Health 12/209/51
6 · The paper itself

Abstract

backgroundSince the introduction of digital health technologies in National Health Service (NHS), health professionals are starting to use email, text, and other digital methods to consult with their patients in a timely manner. There is lack of evidence regarding the economic impact of digital consulting in the United Kingdom (UK) NHS.

objectiveThis study aimed to estimate the direct costs associated with digital consulting as an adjunct to routine care at 18 clinics serving young people aged 16-24 years with long-term conditions.

methodsThis study uses both quantitative and qualitative approaches. Semistructured interviews were conducted with 173 clinical team members on the impacts of digital consulting. A structured questionnaire was developed and used for 115 health professionals across 12 health conditions at 18 sites in the United Kingdom to collect data on time and other resources used for digital consulting. A follow-up semistructured interview was conducted with a single senior clinician at each site to clarify the mechanisms through which digital consulting use might lead to outcomes relevant to economic evaluation. We used the two-part model to see the association between the time spent on digital consulting and the job role of staff, type of clinic, and the average length of the working hours using digital consulting.

resultsWhen estimated using the two-part model, consultants spent less time on digital consulting compared with nurses (95.48 minutes; P<.001), physiotherapists (55.3 minutes; P<.001), and psychologists (31.67 minutes; P<.001). Part-time staff spent less time using digital consulting than full-time staff despite insignificant result (P=.15). Time spent on digital consulting differed across sites, and no clear pattern in using digital consulting was found. Health professionals qualitatively identified the following 4 potential economic impacts for the NHS: decreasing adverse events, improving patient well-being, decreasing wait lists, and staff workload. We did not find evidence to suggest that the clinical condition was associated with digital consulting use.

conclusionsNurses and physiotherapists were the greatest users of digital consulting. Teams appear to use an efficient triage system with the most expensive members digitally consulting less than lower-paid team members. Staff report showed concerns regarding time spent digitally consulting, which implies that direct costs increase. There remain considerable gaps in evidence related to cost-effectiveness of digital consulting, but this study has highlighted important cost-related outcomes for assessment in future cost-effectiveness trials of digital consulting.

Indexed as

costing analysisdiabetesdigital consultinglong-term conditionsmental healthyoung people

Identifiers

PMID30377145
PMCPMC6234335
OpenAlexW2883408685

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.