Pathology perspective on gynaecologic malignancy screening questions in electronic consultation.

Autor:	Wang C; Department of Medicine, University of Ottawa, Canada., Liddy C; C.T. Lamont Primary Health Care Research Centre, Department of Family Medicine, University of Ottawa, Canada.; Bruyère Research Institute, Canada.; Ontario eConsult Centre of Excellence, The Ottawa Hospital, Canada., Afkham A; Champlain Local Health Integration Network, Canada., Islam S; Department of Pathology and Laboratory Medicine, University of Ottawa, Canada., Shehata F; Department of Obstetrics and Gynecology, University of Ottawa, Canada., Posner G; Department of Obstetrics and Gynecology, University of Ottawa, Canada., Keely E; Department of Medicine, University of Ottawa, Canada.; Ontario eConsult Centre of Excellence, The Ottawa Hospital, Canada.; Division of Endocrinology/Metabolism, The Ottawa Hospital, Canada.
Jazyk:	angličtina
Zdroj:	Journal of telemedicine and telecare [J Telemed Telecare] 2021 Feb; Vol. 27 (2), pp. 123-130. Date of Electronic Publication: 2019 Jul 31.
DOI:	10.1177/1357633X19864825
Abstrakt:	Introduction: The electronic consultation service, eConsult, is an asynchronous web-based platform for provider-to-provider consultation with specialists. This study described the utilization of eConsult by primary care providers to obtain specialist opinion in gynaecologic malignancy screening, with a specific focus on pathology-related inquiries. Methods: This is a cross-sectional retrospective review of eConsults submitted to obstetrics/gynaecology between September 2011 and December 2016. All questions pertaining to gynaecologic cancer screening and their pathologies were included. Each question was classified based on a pre-determined taxonomy. The mandatory primary care providers' exit surveys were analysed to determine eConsult's influence on patient care, primary care providers' referral patterns, primary care providers' satisfaction and educational value. Results: In total, 1,357 electronic consultations were submitted to the obstetrics and gynaecology service during the study period, of which 329 met inclusion criteria. Indications for a screening test based on patient risk factors made up 36% of consults pertaining to gynaecologic malignancy screening and 17% were inquiries about test intervals based on previous results. Primary care providers pointed out gaps in current screening guidelines. In total, 38% of primary care providers reported the eConsult service helped avoid a specialist referral, whereas 47% of primary care providers received new or additional courses of action. Pathology report interpretation accounted for 5% of eConsults and 6% of primary care providers wished for clarification of incidental pathology findings. Conclusion: This study uncovered areas of uncertainty among primary care providers regarding gynaecologic cancer screening and gaps in current clinical guidelines. Furthermore, the role of pathology consultants in an eConsult platform is explored and may be extrapolated into practice.
Databáze:	MEDLINE
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