title: Virtual referral system between specialized endocrinological care and primary care.
abstract: OBJECTIVE
  To study the resolution improvement of endocrine diseases in primary care using communication and information technology (IT). Reduce number of inappropriate appointments to specialist care visits. Direct line establishment of communication between primary care and specialist care and provide quick and useful advices to GPs.
  
  
  METHODS
  The GP establishes appointments for patients who need a visit with the specialist of endocrinology without physical presence. The queries are recorded in the medical share history of each patient. If a person requires a visit, the specialist care makes an appointment himself. A descriptive analysis was made based on virtual visits during 2008-2010, using the electronic medical history of patients from 6 GP centers. Adequacy of first visits (according to agreed protocols) between 2007 and 2009 was compared.
  
  
  RESULTS
  Total number of online queries: 1705. Pathology: thyroid 35%, diabetes 50%, obesity 4% and others 11%. The most common virtual queries were the thyroid dysfunctions in 2008 and diabetes in 2010. Diabetes increased from 25.5% to 66%. In 2007 there were 25% of inappropriate first visit which were reduced to 10% in 2009. 88% of queries were resolved virtually.
  
  
  CONCLUSIONS
  There was an increase in the capacity of case resolution in primary care with decrease of inappropriate first visits from primary care to specialist care. Teamwork between hospital and primary care was encouraged. The access of training in endocrine pathology among GP was improved.
authors.affiliation: Unidad de Endocrinología, Hospital de Viladecans, Institut Català de la Salut, Barcelona, España.
authors.forename: Xavier
authors.initials: X
authors.lastname: Oliva
authors.forename: Teresa
authors.initials: T
authors.lastname: Micaló
authors.forename: Sonia
authors.initials: S
authors.lastname: Pérez
authors.forename: Beatriz
authors.initials: B
authors.lastname: Jugo
authors.forename: Silvia
authors.initials: S
authors.lastname: Solana
authors.forename: Carlos
authors.initials: C
authors.lastname: Bernades
authors.forename: Marta
authors.initials: M
authors.lastname: Sanavia
authors.forename: Caridad
authors.initials: C
authors.lastname: Delgado
mesh_terms: D004700:Endocrine System Diseases / Q000628:therapy*; D004704:Endocrinology; D006801:Humans; D008490:Medical Informatics; D011320:Primary Health Care; D012017:Referral and Consultation