Drafting. The electronic consultation maintained by the hematologists of the Virgen del Rocío University Hospital and professionals of the Seville District of Primary Care It has been chosen as one of the Best Ideas of 2019 by Medical Journal in the category of Digital Health and Technology.
The Hematology unit of the Virgen del Rocío University Hospital and the Seville District of Primary Care developed a computer tool last year that has served to create an electronic consultation between specialists. The goal is for the hematologist to solve through it the questions raised by primary doctors about basic disorders of hemograms or coagulation studies that detect in their users in health centers, and thus avoid displacement of the patient to the hospital.
One of the most frequent reasons for referral from Primary Care to the Hematology department It is the presence of abnormalities in the blood count (anemias, thrombopenias, leukocytosis or leukopenia) or in coagulation studies. In order to give immediate support to the primary care physician to solve, if possible, the patient's problem in his health center, this application has been developed that allows direct and agile communication between the primary care physician and the hematologist .
This also prevents the patient from having to make an appointment with the hematologist and, on the other, the move to the query, if not necessary. Instead, he receives in his primary care center the assessment of the specialist in Hematology and Hemotherapy and the proposed treatment for his health problem.
Over the past year, specialists in Hematology and Hemotherapy have received 873 consultations from Primary Care professionals. In 575 cases due to doubts in the interpretation of alterations in the blood count and another 298 consultations directed to the field of coagulation. The average response time has been less than 48 hours.
These data are on the rise, since in the year we have risen to a total of 1,139 tele inquiries: 751 per hematimetry and 388 by coagulation.
The application allows family physicians access to referral criteria divided into two large areas: hematimetry and coagulation. Through a decision tree, the cases of patients that can be solved directly by the physician are defined primary care, those that require some additional study, and finally those in which the hematologist is necessary.
In the latter case, the responsible hematologists give immediate response (in a matter of days) through the computer system, indicating a recommendation on management and the most appropriate treatment, or by considering the referral of the patient to the hospital consultationl if necessary; in this case the day and time of the consultation in the Hematology service is provided in the same communication, which significantly shortens referral and response times.
The application has been implemented throughout the first half of 2018, and it is already operational in all the health centers of the Sevilla District of the Virgen del Rocí Hospital Areao: 22 health centers that serve a total of 426,442 users.
In 71% of the cases, the consultation has been resolved with a response through the computer system by Hematology and, therefore, these patients have not had to go to the hospital's outpatient clinic since their problem of Health in primary school. Only 29% of patients have required an appointment in an outpatient clinic. The reception has been so good that from the primary care centers where the application has been submitted, only 14 interconsultations have been received by the traditional way.
Specific, It is available in the health centers of Lover Laffón, Amate, Bellavista, Cerro del Águila, El Cachorro, El Greco, Juncal, El Porvenir, Fuente del Rey, La Candelaria, La Plata, Las Litanías, Las Palmeritas, Los Bermejales, Mallén, Marqués de Paradas, Palmete, Polígono South, San Luis, San Pablo, Torreblanca, and Virgin of Africa. The initial reception has been very satisfactory and there is a continuous evaluation process, in order to collect the impressions of primary care doctors.
Satisfaction questionnaires regarding this electronic consultation conducted among primary care physicians show that more than 85% are satisfied or Very satisfied with its operation and consider it a useful tool.