Evidence map›Paper›PMID 35022061›Full record

ArticleBMC health services research2022

Analysis of the implementation of an innovative IT solution to improve waiting times, communication with primary care and efficiency in Rheumatology.

José María Pego-Reigosa, Carlos Peña-Gil, David Rodríguez-Lorenzo, Irene Altabás-González, Naír Pérez-Gómez, John Henry Guzmán-Castro, Rodrigo Varela-Gestoso, Reyes Díaz-Lambarri, Alberto González-Carreró-López, Olga Míguez-Senra and 9 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC health services research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Review
  4. A glance into the future of diagnosis and treatment of spondyloarthritis.Therapeutic advances in musculoskeletal disease · 2022
    Review
  5. 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

19 authors.

José María Pego-ReigosaRheumatology Department, University Hospital of Vigo, Vigo Health Area, Alto do Meixoeiro s/n, 36200, Vigo, Spain. jose.maria.pego.reigosa@sergas.es.ORCID https://orcid.org/0000-0003-3461-3537
Carlos Peña-GilCardiology Department, Santiago de Compostela Health Area, Santiago de Compostela, Spain.
David Rodríguez-LorenzoQuality Department, Vigo Health Area, Vigo, Spain.
Irene Altabás-GonzálezRheumatology Department, University Hospital of Vigo, Vigo Health Area, Alto do Meixoeiro s/n, 36200, Vigo, Spain.
Naír Pérez-GómezRheumatology Department, University Hospital of Vigo, Vigo Health Area, Alto do Meixoeiro s/n, 36200, Vigo, Spain.
John Henry Guzmán-CastroRheumatology Department, University Hospital of Vigo, Vigo Health Area, Alto do Meixoeiro s/n, 36200, Vigo, Spain.
Rodrigo Varela-GestosoInformation Technology Department, Vigo Health Area, Vigo, Spain.
Reyes Díaz-LambarriPrimary Care Direction, Vigo Health Area, Vigo, Spain.
Alberto González-Carreró-LópezHealth Information Department, Vigo Health Area, Vigo, Spain.
Olga Míguez-SenraHealth Information Department, Vigo Health Area, Vigo, Spain.
Julia Bóveda-FontánPintor Colmeiro Primary Care Center, Vigo, Spain.
Ángeles Charle-CrespoPrimary Care Center of Porriño, Vigo Health Area, Vigo, Spain.
Francisco Javier Caramés-CasalPrimary Care Center of Marín, Marín, Spain.
Ceferino Barbazán-ÁlvarezRheumatology Department, University Hospital of Vigo, Vigo Health Area, Alto do Meixoeiro s/n, 36200, Vigo, Spain.
Íñigo Hernández-RodríguezRheumatology Department, University Hospital of Vigo, Vigo Health Area, Alto do Meixoeiro s/n, 36200, Vigo, Spain.
Francisco Maceiras-PanRheumatology Department, University Hospital of Vigo, Vigo Health Area, Alto do Meixoeiro s/n, 36200, Vigo, Spain.
Marina Rodríguez-LópezRheumatology Department, University Hospital of Vigo, Vigo Health Area, Alto do Meixoeiro s/n, 36200, Vigo, Spain.
Rafael Melero-GonzálezRheumatology Department, University Hospital of Vigo, Vigo Health Area, Alto do Meixoeiro s/n, 36200, Vigo, Spain.
José Benito Rodríguez-FernándezPrimary Care Center of Covelo, Vigo Health Area, Vigo, Spain.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo describe in detail an innovative program based on telemedicine for semi-automated prioritization of referrals from Primary Care (PC) to Rheumatology, for reproducibility purposes, and to present the results of the implementation study.

methodsThe context and situation were carefully analyzed, paying attention to all processes in place, referral numbers, waiting times, and number of complementary tests prior to discharge from Rheumatology. The composition of the team, aims, users, scope, and implementation phases were defined. Eight process indicators were established and measured before and 32 months after the program implementation.

resultsThe program, which includes IT circuits, algorithms based on response to specific guideline-based checklists, e-consultation, and appointments based on priority, was fully implemented in our health area after a pilot study in two PC centers. After implementation, 6185 rheumatology referrals showed an e-consultation response delay of 8.95 days, and to first face-to-face visit (after e-consultation) of 12.6 (previous delay before program implementation was 83.1 days). Resolution by e-consultation reached 20% (1195 patients did not need seeing the rheumatologist to have the problem solved), and 1369 patients (32%) were discharged after the first visit. The overall resolution rate was 44.0% (2564 discharges/5830 e-consultations). From a random sample of 100 visits, only 10% of patients needed additional complementary tests to make a diagnosis and decision by Rheumatology (20.9% decrease from previous period).

conclusionA careful analysis of the situation and processes, with implementation of simple IT circuits, allows for the improvement of the efficiency and resolution of problems in Rheumatology.

Indexed as

RheumatologyCommunicationHumansPilot ProjectsPrimary Health CareReferral and ConsultationReproducibility of ResultsWaiting ListsEarly diagnosisImplementationMedical informaticsNeeds assessmentRheumatic diseasesTelemedicine

Identifiers

PMID35022061
PMCPMC8754366

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.