Email triage of new neurological outpatient referrals from general practice.
OBJECTIVE
To determine whether an email triage system between general practitioners and a neurologist for new outpatient referrals is feasible, acceptable, efficient, safe, and effective.


METHODS
This was a prospective single cohort study on the interface between primary care practitioners and the neurology clinic of a district general hospital. Seventy six consecutive patients with neurological symptoms from nine GPs, for whom a specialist opinion was deemed necessary, were entered in the study. The number of participants managed without clinic attendance and the reduction in neurologist's time compared with conventional consultation was measured, as was death, other specialist referral, and change in diagnosis in the 6 months after episode completion. The acceptability for GPs was ascertained by questionnaire.


RESULTS
Forty three per cent of participants required a clinic appointment, 45% were managed by email advice alone, and 12% by email plus investigations. GP satisfaction was high. Forty four per cent of the neurologist's time was saved compared with conventional consultation. No deaths or significant changes in diagnosis were recorded during the 6 month follow up period.


CONCLUSIONS
Email triage is feasible, acceptable to GPs, and safe. It has the potential for making the practice of neurologists more efficient, and this needs to be tested in a larger randomised study.
Patterson
V
V
Department of Neurology, Neurology Ward 4E, Royal Victoria Hospital, Grosvenor Road, Belfast BT12 6BA, N. Ireland, UK. tele.neuro@royalhospitals.n-i.nhs.uk
Humphreys
J
J
Chua
R
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D001291:Attitude of Health Personnel; D003627:Data Interpretation, Statistical; D034742:Electronic Mail / Q000706:statistics & numerical data*; D005194:Family Practice; D005240:Feasibility Studies; D005260:Female; D006748:Hospital Departments / Q000706:statistics & numerical data*; D006801:Humans; D007494:Ireland; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000145:classification / Q000175:diagnosis* / Q000453:epidemiology; D009460:Neurologic Examination / Q000706:statistics & numerical data; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012984:Software; D013996:Time and Motion Studies; D014218:Triage / Q000706:statistics & numerical data*