Impacts of electronic communication systems between primary and specialized care: an integrative review

Authors

DOI:

https://doi.org/10.33448/rsd-v10i10.18805

Keywords:

Remote Consultation; Health Services Accessibility; Primary Health Care; Secondary Care; Referral and consultation.

Abstract

Interprofessional communication platforms have shown promise in the articulation between primary and specialized care. This article sought to analyze the health impacts resulting from the use of electronic communication systems between general practitioners and specialists. An integrative review was carried out in the BVS, PubMed and Scielo databases, and an analysis of gray literature in the Google Scholar platform, without a time filter. After applying the inclusion and exclusion criteria, 27 studies were selected. These were published between 2000 and 2020, were mostly Canadian studies, and had electronic systems developed for multiple specialties as predominant. Through a variety of approaches, the articles highlighted a reduction in referral rates to specialized care services, cost savings and improvement in the quality of health care provided by primary care as impacts resulting from the use of interprofessional communication platforms.

References

Almeida, P. F., Gérvas, J., Freire, J. M. & Giovanella, L. (2013). Estratégias de integração entre atenção primária à saúde e atenção especializada: paralelos entre Brasil e Espanha. Saúde debate, 37(98), 400-415.

Archibald, D., Stratton, J., Liddy, C., Grant, R. E., Green, D. & Keely, E. J. (2018). Evaluation of an electronic consultation service in psychiatry for primary care providers. BMC Psychiatry, 18, 119.

Belber, G. S., Passos, V. C. S., Borysow, I. C. & Maeyama, M. A. (2021). Contribuições do Programa Nacional Telessaúde Brasil Redes na formação de recursos humanos na atenção básica. Braz J of Develop, 7(1), 1198-1219.

Bernardino Junior, S. V., Medeiros, C. R. G., Souza, C. F., Kich, J., Alves, A. M. & Castro, L. C. (2020). Processos de encaminhamento a serviços especializados em cardiologia e endocrinologia pela Atenção Primária à Saúde. Saúde debate, 44(126), 694-707.

Botelho, L. L. R. B., Cunha, C. C. A. C. & Macedo, M. (2011). O método da revisão integrativa nos estudos organizacionais. Gestão e Sociedade, 5(11), 121-136.

Carrard, V. C., Roxo Gonçalves, M., Rodriguez Strey, J., Pilz, C., Martins, M., Martins, M. D., Schmitz, C. A., Dal Moro, R. G., D’Ávila, O. P., Drv Rados, Harzheim, E. & Gonçalves, M. R. (2018). Telediagnosis of oral lesions in primary care: The EstomatoNet Program. Oral Dis, 24(6), 1012–1019.

Chittle, M. D., Rao, S. K., Jaff, M. R., Patel, V. I., Gallen, K. M., Avadhani, R., Ferris, T. G. & Wasfy, J. H. (2015). Asynchronous vascular consultation via electronic methods: A feasibility pilot. Vasc Med, 20(6), 551–556.

Farias, C. M. L., Giovanella, L., Oliveira, A. E. & Santos Neto, E. T. (2019). Tempo de espera e absenteísmo na atenção especializada: um desafio para os sistemas universais de saúde. Saúde debate, 43(spe5), 190-204.

Fogel, A., Khamisa, K., Afkham, A., Liddy, C. & Keely, E. (2016). Ask the eConsultant: Improving access to haematology expertise using an asynchronous eConsult system. J Telemed Telecare, 23(3), 421–427.

Gilani, S., Bommakanti, K. & Friedman, L. (2020). Electronic Consults in Otolaryngology: A Pilot Study to Evaluate the Use, Content, and Outcomes in an Academic Health System. Ann Otol Rhinol Laryngol, 129 (2), 170-174.

Harno, K., Paavola, T., Carlson, C. & Viikinkoski, P. (2000). Patient referral by telemedicine: effectiveness and cost analysis of an intranet system. J Telemed Telecare, 6(6), 320–329.

Jaatinen, P. T., Aarnio, P., Remes, J., Hannukainen, J. & Köymäri-Seilonen, T. (2002). Teleconsultation as a replacement for referral to an outpatient clinic. J Telemed Telecare, 8(2), 102–106.

Johnston, D. L., Murto, K., Kurzawa, J., Liddy, C., Keely, E. & Lai, L. (2017). Use of Electronic Consultation System to Improve Access to Care in Pediatric Hematology/Oncology. J Pediatr Hematol Oncol, 39(7), e367–e369.

Joschko, J., Keely, E., Grant, R., Moroz, I., Graveline, M., Drimer, N. & Liddy, C. (2018). Electronic Consultation Services Worldwide: Environmental Scan. J Med Internet Res, 20(12), e11112.

Katz, N., Roman, R., Rados, D. V., Oliveira, E. B., Schmitz, C. A. A., Gonçalves, M. R., Mengue, S. S. & Umpierre, R. N. (2020). Acesso e regulação ao cuidado especializado no Rio Grande do Sul: a estratégia RegulaSUS do TelessaúdeRS-UFRGS. Ciênc. saúde coletiva, 25(4), 1389-1400.

Knox, M., Murphy, E. J., Leslie, T., Wick, R. & Tuot, D. S. (2020). e-Consult implementation success: lessons from 5 county-based delivery systems. Am J Manag Care, 26(1), e21–e27.

Kohlert, S., Murphy, P., Tse, D., Liddy, C., Afkham, A. & Keely, E. (2018). Improving access to otolaryngology-head and neck surgery expert advice through eConsultations. Laryngoscope, 128(2), 350–355.

Lacasta Tintorer, D., Manresa Domínguez, J. M., Jiménez-Zarco, A., Rodríguez-Blanco, T., Flayeh Beneyto, S., Torán-Monserrat, P., Tuduri, X. M. & Saigí-Rubió, F. (2020). Efficiency as a determinant of loyalty among users of a Community of Clinical Practice: a comparative study between the implementation and consolidation phases. BMC Fam Pract, 21(1), 15.

Liddy, C., Bello, A., Cook, J., Drimer, N., Pilon, M. D., Farrell, G., Glassford, J., Ireland, L., McDonald, R., Nabelsi, V., Oppenheimer, L., Singer, A. & Keely, E. (2019b). Supporting the spread and scale-up of electronic consultation across Canada: cross-sectional analysis. BMJ Open, 9(5).

Liddy, C., Drosinis, P., Deri Armstrong, C., McKellips, F., Afkham, A. & Keely, E. (2016a). What are the cost savings associated with providing access to specialist care through the Champlain BASE eConsult service? A costing evaluation. BMJ open, 6(6), e010920.

Liddy, C., Moroz, I., Keely, E., Taljaard, M., Deri Armstrong, C., Afkham, A. & Kendall, C. E. (2019a). Understanding the impact of a multispecialty electronic consultation service on family physician referral rates to specialists: a randomized controlled trial using health administrative data. Trials, 20(1), 348.

Liddy, C., Moroz, I., Mihan, A. & Keely, E. (2019c). Assessment of the Generalizability of an eConsult Service through Implementation in a New Health Region. J Am Board Fam Med, 32(2), 146-157.

Liddy, C., Moroz, I., Mihan, A., Nawar, N. & Keely, E. (2019d). A Systematic Review of Asynchronous, Provider-to-Provider, Electronic Consultation Services to Improve Access to Specialty Care Available Worldwide. Telemed J E Health, 25(3), 184-198.

Liddy, C., Smyth, C., Poulin, P. A., Joschko, J., Rebelo, M. & Keely, E. (2016b). Improving Access to Chronic Pain Services Through eConsultation: A Cross-Sectional Study of the Champlain BASE eConsult Service. Pain Med, 17(6), 1049-1057.

Mann, R. & van de Weijer, P. H. M. (2018). Adopting innovation in gynaecology: The introduction of e-consult. Aust N Z J Obstet Gynaecol, 58(4), 449–453.

Mehrtens, S. H., Shall, L. & Halpern, S. M. (2019). A 14-year review of a UK teledermatology service: experience of over 40 000 teleconsultations. Clin Exp Dermatol, 44(8), 874-881.

Ministério da Saúde. (n.d.). Saúde Digital e Telessaúde. Página inicial. https://saudedigital.saude.gov.br/telessaude/

Olayiwola, J. N., Potapov, A., Gordon, A., Jurado, J., Magana, C., Knox, M. & Tuot, D. (2019). Electronic consultation impact from the primary care clinician perspective: Outcomes from a national sample. J Telemed Telecare, 25(8), 493-498.

Organização Pan-Americana da Saúde. (2011). A atenção à saúde coordenada pela APS: construindo as redes de atenção no SUS: contribuições para o debate. Brasília: Organização Pan-Americana da Saúde. https://iris.paho.org/handle/10665.2/18457

Paiva, T., Coelho, H., Araújo, M. T., Rodrigues, R., Almeida, A., Navarro, T., Cruz, M., Carneiro, G. & Belo, C. (2001). Neurological teleconsultation for general practitioners. J Telemed Telecare, 7(3), 149-54.

Piette, E., Nougairède, M., Vuong, V., Crickx, B. & Tran, V-T. (2017). Impact of a store-and-forward teledermatology intervention versus usual care on delay before beginning treatment: A pragmatic cluster-randomized trial in ambulatory care. J Telemed Telecare, 23(8), 725–732.

Ray, K. N. & Kahn, J. M. (2020). Connected Subspecialty Care: Applying Telehealth Strategies to Specific Referral Barriers. Acad Pediatr, 20(1), 16-22.

Scalvini, S., Rivadossi, F., Comini, L., Muiesan, M. L. & Glisenti, F. (2011). Telemedicine: The role of specialist second opinion for GPs in the care of hypertensive patients. Blood Press, 20(3), 158–165.

Scalvini, S., Tridico, C., Glisenti, F., Giordano, A., Pirini, S., Peduzzi, P. & Auxilia, F. (2009). The SUMMA Project: A Feasibility Study on Telemedicine in Selected Italian Areas. Telemed j e. health, 15(3), 261–269.

Schettini, P., Shah, K. P., O’Leary, C. P., Patel, M. P., Anderson, J. B., Cho, A. H., Long, A. L., Bosworth, H. B. & Blake Cameron, C. (2019). Keeping care connected: e-Consultation program improves access to nephrology care. J Telemed Telecare, 25(3), 142-150.

Stoves, J., Connolly, J., Cheung, C. K., Grange, A., Rhodes, P., O’Donoghue, D. & Wright, J. (2010). Electronic consultation as an alternative to hospital referral for patients with chronic kidney disease: a novel application for networked electronic health records to improve the accessibility and efficiency of healthcare. Qual Saf Health Care, 19(5), e54.

Tuot, D. S., Liddy, C., Vimalananda, V. G., Pecina, J., Murphy, E. J., Keely, E., Simon, S. R., North, F., Orlander, J. D. & Chen, A. H. (2018). Evaluating diverse electronic consultation programs with a common framework. BMC health services research, 18(1), 814.

van den Akker, T. W., Reker, C. H., Knol, A., Post, J., Wilbrink, J. & van der Veen, J. P. (2001). Teledermatology as a tool for communication between general practitioners and dermatologists. J Telemed Telecare, 7(4), 193-8.

van der Heijden, J. P., de Keizer, N. F., Bos, J. D., Spuls, P. I. & Witkamp, L. (2011). Teledermatology applied following patient selection by general practitioners in daily practice improves efficiency and quality of care at lower cost. Br J Dermatol, 165(5), 1058-65.

van der Velden, T., Schalk, B. W. M., Harmsen, M., Adriaansens, G., Schermer, T. R. & Ten Dam, M. A. (2019). Implementation of web-based hospital specialist consultations to improve quality and expediency of general practitioners’ care: a feasibility study. BMC Fam Pract, 20(1), 73.

van Gelder, V. A., Scherpbier-de Haan, N. D., van Berkel, S., Akkermans, R. P., de Grauw, I. S., Adang, E. M., Assendelft, P. J., de Grauw. W. J. C., Biermans, M. C. J. & Wetzels, J. F. M. (2017). Web-based consultation between general practitioners and nephrologists: a cluster randomized controlled trial. Fam Pract, 34(4), 430-436.

Vidal-Alaball, J., Garcia Domingo, J. L., Garcia Cuyàs, F., Mendioroz Peña, J., Flores Mateo, G., Deniel Rosanas, J. & Valmaña, G. S. (2018). A cost savings analysis of asynchronous teledermatology compared to face-to-face dermatology in Catalonia. BMC Health Serv Res, 18(1), 650.

Published

08/08/2021

How to Cite

MUNIZ, M. C. H.; SANTOS, M. A. dos; ARAÚJO, B. C. L.; OLIVEIRA, A. A. de; SIMÕES, S. de M. Impacts of electronic communication systems between primary and specialized care: an integrative review. Research, Society and Development, [S. l.], v. 10, n. 10, p. e186101018805, 2021. DOI: 10.33448/rsd-v10i10.18805. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/18805. Acesso em: 5 nov. 2024.

Issue

Section

Health Sciences