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Electronic Consultation Support System for Radiocontrast Media Hypersensitivity Changes Clinicians' Behavior.

ABSTRACT: PURPOSE:Patients with a history of radiocontrast media (RCM) hypersensitivity can be overlooked, resulting in repeated reactions. Therefore, a consultation support system for RCM hypersensitivity has been in operation at Seoul National University Bundang Hospital since December 2011. We analyzed the effect of this system on physicians' practice. METHODS:A retrospective study was conducted on patients with previous RCM reactions (December 1, 2010 to November 30, 2012). The control period was December 2010 to November 2011, and the intervention period was December 2011 to November 2012. The primary outcome was the composite outcome of premedication and consultation. Premedication was defined as preventive medication prescribed by the physician who ordered RCM-enhanced computed tomography (CT) at the same time. The secondary outcome was the recurrence rate after using the consultation support system. RESULTS:A total of 189 clinicians prescribed 913 CT scans during the control period and 225 clinicians performed 1,153 examinations during the intervention period. The odds ratio (OR) of achieving the composite outcome increased significantly after use of the consultation support system (OR, 1.54; 95% confidence interval [CI], 1.15-2.05). Clinicians in both medical (OR, 1.48; 95% CI, 1.06-2.07) and surgical (OR, 2.07; 95% CI, 1.24-3.46) departments showed significant changes in their behavior, whereas those in the emergency department did not (OR, 1.07; 95% CI, 0.41-2.78). Professors (OR, 1.47; 95% CI, 1.06-2.04) and trainees (OR, 1.97, 95% CI, 1.22-3.18) showed significant changes in their behavior toward patients with previous RCM reactions. The behavior of 86 clinicians who ordered CT scans during both the control and intervention periods was unchanged. CONCLUSIONS:The consultation support system for those with previous RCM hypersensitivity reactions changed physicians' practice patterns and decreased recurrent RCM hypersensitivity reactions as well.

SUBMITTER: Yang MS

PROVIDER: S-EPMC5809765 | biostudies-literature | 2018 Mar

REPOSITORIES: biostudies-literature

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Electronic Consultation Support System for Radiocontrast Media Hypersensitivity Changes Clinicians' Behavior.

Yang Min Suk MS Choi Sang Il SI Song Woo Jung WJ Kim Sae Hoon SH Cho Sang Heon SH Min Kyung Up KU Kim Jae Hyoung JH Chang Yoon Seok YS

Allergy, asthma & immunology research 20180301 2

<h4>Purpose</h4>Patients with a history of radiocontrast media (RCM) hypersensitivity can be overlooked, resulting in repeated reactions. Therefore, a consultation support system for RCM hypersensitivity has been in operation at Seoul National University Bundang Hospital since December 2011. We analyzed the effect of this system on physicians' practice.<h4>Methods</h4>A retrospective study was conducted on patients with previous RCM reactions (December 1, 2010 to November 30, 2012). The control ...[more]

PMID: 29411557

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Project description:BACKGROUND:Excessive wait times for specialist care pose a serious concern for many patients, leading to duplication of tests, patient anxiety, and poorer health outcomes. In response to this issue, many health care systems have begun implementing technological innovations designed to improve the referral-consultation process. Among these services is electronic consultation (eConsult), which connects primary care providers and specialists through a secure platform to facilitate discussion of patients' care. OBJECTIVE:This study aims to examine different eConsult services available worldwide and compare the strategies, barriers, and successes of their implementation in different health care contexts. METHODS:We conducted an environmental scan comprising 3 stages as follows: literature review; gray literature search; and targeted, semistructured key informant interviews. We searched MEDLINE and EMBASE (literature review) and Google (gray literature search). Upon completing the search, we generated a list of potential interview candidates from among the stakeholders identified. Potential participants included researchers, physicians, and decision makers. The maximum variation sampling was used to ensure sufficient breadth of participant experience. In addition, we conducted semistructured interviews by telephone using an interview guide based on the RE-AIM framework. Analyses of transcripts were conducted using a thematic synthesis approach. RESULTS:A total of 53 services emerged from the published and gray literature. Respondents from 10 services participated in telephonic interviews. The following 4 major themes emerged from the analysis: service structure; benefits of eConsult; implementation challenges; and implementation enablers. CONCLUSIONS:eConsult services have emerged in a variety of countries and health system contexts worldwide. Despite differences in structure, platform, and delivery of their services, respondents described similar barriers and enablers to the implementation and growth and reported improved access and high levels of satisfaction.

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Electronic Consultation Support System for Radiocontrast Media Hypersensitivity Changes Clinicians' Behavior.

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Electronic Consultation Support System for Radiocontrast Media Hypersensitivity Changes Clinicians' Behavior.

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