Identification of indicators used to assess needs for telemedicine consultations in various profiles of medical care

Abstract

BACKGROUND: A unified system for assessing the results and real contributions of telemedicine consultations to improving medical care quality in the healthcare system of the Russian Federation has not yet been developed. AIM: To develop a system of indicators for differentiated assessment of the needs for telemedicine consultations in the provision of medical care. MATERIALS AND METHODS: In the first stage, reports on the results of on-site activities of national medical research centers in regions of the Russian Federation and their annual public reports (2020–2022) were analyzed to identify indicators that determine the need for telemedicine consultations. The identified indicators were clarified and validated in an open interview with the representatives of the national medical research centers. In the second stage, the value of each indicator was determined based on the expert survey: 18 experts assessed each indicator on a scale of 1–5. Then, the weight coefficient of each indicator was calculated for their subsequent use in planning the coverage of telemedicine consultations. RESULTS: Three groups of indicators that determined the need for telemedicine consultations for different medical care profiles were as follows: (1) indicators that affect the planned volumes of telemedicine consultations, (2) indicators that characterize the efficiency and effectiveness of telemedicine consultations, and (3) indicators that characterize the validity of requests for telemedicine consultations. Group 1 included indicators of lethality, disability, hospital mortality, frequency of emergency/urgent consultations, and frequency of consultations of patients requiring intensive care. Group 2 included indicators for assessing the effectiveness and efficiency of telemedicine consultations, both subjective (result satisfaction) and objective (number of positive and negative treatment and hospitalization outcomes for cases that received where telemedicine consultations). Group 3 included indicators that characterize the validity of requests for telemedicine consultations: thoroughness of a patient’s examination before a telemedicine consultation and accuracy of the diagnosis. The weight coefficients of group 1 indicators ranged from 0.05 to 1.61 and varied for different profiles. CONCLUSION: A system of indicators was proposed for the differentiated assessment of the needs for telemedicine consultations when providing medical care.