Abstract
Abstract
Introduction
Since 2000, an increasing misuse of emergency services in Belgium was noticed. In 2015, a multidisciplinary task-force designed a triage system. Trained operators and integrated triage protocols were installed in a call center for life-threatening and non-life-threatening care needs. Teleconsultations by telephone find their way to planned care and are well studied in this context. Also unplanned care might benefit from telephone-consultations.
Method
This intervention study investigated the feasibility of teleconsultations in unplanned care according to medical doctors. They were present at the call center during the weekend and on public holidays in the period of April 17, 2021 to November 21, 2021. Their task was to call patients who had contacted the call center to perform a teleconsultation, without interfering with regular care.
Results
21 triage doctors participated in the study, they completed 59 surveys and conducted 551 teleconsultations. They perceived the quality of the consultations as good with an average score of 82.85 out of 100 on the sliding scale. The doctors gave an average score of 72.40 for the level of certainty for diagnosis and treatment. For 415 consultations, triage doctors judged that the consultation would gain certainty if followed by a physical examination. Video was mainly considered to be valuable in psychiatric problems, allergic reactions and skin problems.
Discussion
This study showed that teleconsultations are feasible in unplanned care. Videos add value in particular cases. Only few barriers are reported in terms of communication, technology and equipment.
Conclusion
Teleconsultations in unplanned primary care could be performed with a high quality and a sufficient level of certainty. The willingness to conduct teleconsultations in unplanned care is high. It would be useful in a future study to investigate the feasibility, obstacles and needs for implementation of video consultations as they may differ from teleconsultations.
Publisher
Springer Science and Business Media LLC
Subject
Public Health, Environmental and Occupational Health
Reference16 articles.
1. Brasseur E, Gilbert A, Servotte JC, Donneau AF, D’Orio V, Ghuysen A. Emergency department crowding: why do patients walk-in? Acta Clin Belg. 2019:1–7.
2. Van den Heede KDC, Devriese S, Baier N, Camaly O, Depuijdt E, Geissler A, Ghesquiere A, Misplon S, Quentin W, Van Loon C. Voorde C Organisatie en financiering van spoeddiensten in België: huidige situatie en opties voor hervorming Health Services Research (HSR) Brussel: Federaal Kenniscentrum voor de Gezondheidszorg (KCE) 2016 KCE Reports 263As D/2016/10273/21. 2016.
3. Van der Mullen CQH, Van Baelen S, Crits T, Wuyts J, Sabbe M. De patiënt met een niet-planbare zorgvraag naar het gepaste zorgniveau verwijzen: nieuwe 112–1733 geïntegreerde telefonische triage- en regulatieprotocollen. Tijdschrift voor Geneeskunde. 2017;73:241–7.
4. Schoenmakers B, Van Criekinge J, Boeve T, Wilms J, Van Der Mullen C, Sabbe M. Co-location of out of hours primary care and emergency department in Belgium: patients’ and physicians’ view. BMC Health Serv Res. 2021;21(1):282.
5. Schoenmakers B, Delmeiren L, Pietermans S, Janssens M, Van Der Mullen C, Sabbe M. The implementation of the nationwide out-of-hours phone number 1733 in Belgium: analysis of efficiency and safety. Prim Health Care Res Dev. 2021;22:e7.