Medical teleconsultation to general practitioners reduces the medical error vulnerability of internal medicine patients.
BACKGROUND
e-Health strategies are supposed to improve the performance of national health systems. Medical teleconsultation (MT) is an important component of such e-Health strategies.


OBJECTIVE
The outcome of MT was evaluated with regard to the impact on the medical error vulnerability (MEV) of internal medicine patients.


METHODS
A team of internal medicine doctors plus a network of forty specialists was set-up in one health district belonging to a unified and universal national health system of a country of Western Europe, in order to provide free-of-charge MT to support general practitioners in solving internal medicine cases. In this observational study, the case series of 2013 is reviewed.


RESULTS
a) Only 21% of the MT fell short to the general practitioner's expectations about the case solving focus; b) throughout the medical care process of the patient, 49% of the cases met with one or more of the five MEVs, namely: 1) clinical test mishandling; 2) inaccurate differential diagnosis; 3) inadequate information flow between health providers at different levels of care (transition care); 4) poor coordination between health providers; and 5) poor reconciliation of medications or hazardous therapies. c) MT canceled or prevented MEVs in 56% and mitigate MEVs in 15% of the cases; d) MT canceled or prevented 85% of MEV caused by poor information exchange in transition care, therefore improving patient referral and counter-referral.


CONCLUSIONS
MT reduces MEV and therefore, whenever implemented to a large extent, may improve the quality of health care delivery and the performance of national health systems.
Telemedicine Unit of the University of the State of Amazonas, Brazil. Electronic address: campanando@gmail.com.
Nando
N
Campanella
Internal Medicine Department of Ascoli Piceno, Marche Region Health District, Italy.
Pierpaolo
P
Morosini
Marche Region Health District, Italy.
Guido
G
Sampaolo
Marche Region Health District, Italy.
Vania
V
Catozzo
Birkbeck University of London, United Kingdom.
Andrea
A
Caso
Cytopathology Unit, Marche Polytechnic University Hospital, Italy.
Maurizio
M
Ferretti
Marche Polytechnic University Hospital, Italy.
Moreno
M
Giovagnoli
Medical Oncology Unit, Marche Polytechnic University Hospital, Italy.
Mariangela
M
Torniai
Radiology Department, Marche Polytechnic University Hospital, Italy.
Ettore
E
Antico
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003695:Delivery of Health Care / Q000592:standards*; D005060:Europe; D005260:Female; D058005:General Practitioners / Q000592:standards*; D006801:Humans; D007223:Infant; D007388:Internal Medicine; D008297:Male; D019300:Medical Errors / Q000517:prevention & control*; D008875:Middle Aged; D019114:Remote Consultation; D055815:Young Adult
General practitioner; Health system; Medical error vulnerability; Teleconsultation; WHO