Evaluating e-consultation implementation in Sleep Apnoea-Hypopnoea Syndrome (SAHS)

Abstract

Background: Access to specialist advice remains a barrier for many Primary Care Providers (PCP). We’ve developed an electronic consultation system based on a secure web-based tool as an alternative to traditional consultation. We decided to focus this e-consulting on SAHS as it was deemed to be representative of a high prevalence syndrome. Aims: to study the implementation of an e-consultation service between PCP and a Respiratory Unit as a first consultation about SAHS. Methods: Prospective and pilot study of a secure, web-based e-consultation, from the Regional Health Care Service in Aragon (Spain), developed between our Respiratory Unit and PCP, included in the Hospital health area (250,000 patients per area). Web-messaging via the Internet were sent from PCP and replied by a pneumologist designated for that purpose. The e-consult cycle time was completed within 72 hours. This study took place from March 1, 2018 to December 28, 2018. Results: Total pulmonary consultations: 1357 SAHS related consultations: 433 (31,9%). Answers provided by the specialists (about SAHS): –235 cases (54,2%) underwent directly to home poligraphy (as STOP BANG questionnaire filled out by PCP >4) –17 cases were submitted for treatment, since they reported poligraphic studies carried out previously –7 cases were refused as SAHS –In 60 cases more information was required –114 cases were included as questions about other items Conclusions: The implementation of e-consultation service, increase access to specialty clinics, improve the quality of consultation, reduce the wait times for patients and can lead to overall cost savings for the health care system in a high prevalence syndrome such as SAHS