The impact of hematology electronic consultations on the management of iron deficiency

IF 2.3 3区 医学 Q2 HEMATOLOGY European Journal of Haematology Pub Date : 2024-07-12 DOI:10.1111/ejh.14276
Hannah L. King, Genevieve B. Benedetti, Stefan Barisic, Virginia Tan, Marie E. Piatski, Jacob M. Berkowitz, Ashley E. Benson, Jamie O. Lo, Sven R. Olson, Thomas G. DeLoughery, Joseph J. Shatzel, Kylee L. Martens
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Abstract

Objectives

Delays in the evaluation and treatment of iron deficiency can lead to increased disease-related morbidity and mortality. Electronic consultation (e-consult) is a referral modality that allows providers quicker access to recommendations from a specialist based on electronic chart review. While the use of e-consult is expanding in classical hematology, gaps exist in the understanding of patient outcomes related to its use for iron deficiency.

Methods

We randomly selected 200 e-consults and 200 traditional referrals from 3,336 hematology referrals for iron deficiency at a single center. The primary outcomes of the retrospective analysis were: time to completion of the referral, and time to treatment with intravenous iron. Secondary outcomes included recurrence of iron deficiency, need for repeat e-consult, conversion to in-person evaluation, and assessment of whether the etiology of iron deficiency was addressed.

Results

E-consults significantly reduced the time from referral to intravenous iron repletion (e-consult, 33 days; traditional referral, 68 days; p < .05). Assessment of the underlying etiology occurred in 70.7% of the e-consult encounters compared to 92.5% of traditional referrals (p < .05).

Conclusions

These findings highlight advantages of e-consults in improving care delivery in iron deficiency, and identifying gaps that can be improved through practice standardization to ensure equitable, high-value care.

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血液学电子会诊对缺铁症管理的影响。
目标:延误对缺铁症的评估和治疗会导致与疾病相关的发病率和死亡率上升。电子会诊(e-consult)是一种转诊模式,可让医疗服务提供者根据电子病历审查更快地获得专家建议。虽然电子会诊在传统血液学领域的应用正在不断扩大,但人们对使用电子会诊治疗缺铁症的患者疗效的了解还存在差距:我们从一个中心的 3336 例血液科缺铁症转诊病例中随机抽取了 200 例电子会诊和 200 例传统转诊病例。回顾性分析的主要结果是:完成转诊的时间和接受静脉铁剂治疗的时间。次要结果包括铁缺乏症的复发、重复电子会诊的需要、转为面诊评估,以及对铁缺乏症病因是否得到解决的评估:结果:电子会诊大大缩短了从转诊到静脉补铁的时间(电子会诊,33 天;传统转诊,68 天;P 结论:电子会诊的优势在于它可以减少患者从转诊到静脉补铁的时间(电子会诊,33 天;传统转诊,68 天):这些研究结果凸显了电子会诊在改善铁缺乏症护理服务方面的优势,并找出了可通过实践标准化改善的不足之处,以确保公平、高价值的护理。
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来源期刊
CiteScore
5.50
自引率
0.00%
发文量
168
审稿时长
4-8 weeks
期刊介绍: European Journal of Haematology is an international journal for communication of basic and clinical research in haematology. The journal welcomes manuscripts on molecular, cellular and clinical research on diseases of the blood, vascular and lymphatic tissue, and on basic molecular and cellular research related to normal development and function of the blood, vascular and lymphatic tissue. The journal also welcomes reviews on clinical haematology and basic research, case reports, and clinical pictures.
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