Implementation of an electronic surgical referral service. Collaboration, consensus and cost of the surgeon – general practitioner Delphi approach
Knut Magne Augestad,1–3 Arthur Revhaug,1,3 Roar Johnsen,4 Stein-Olav Skrøvseth,2 Rolv-Ole Lindsetmo1,3 1Department of Gastrointestinal Surgery, 2Department of Integrated Care and Telemedicine, University Hospital North Norway, Tromsø, Norway; 3Department of Colorectal Surgery, University Hospitals C...
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ftdovepress:oai:dovepress.com/18249 2023-05-15T17:39:24+02:00 Implementation of an electronic surgical referral service. Collaboration, consensus and cost of the surgeon – general practitioner Delphi approach Augestad,Knut Magne Revhaug,Arthur Johnsen,Roar Skrøvseth,Stein-Olav Lindsetmo,Rolv-Ole 2014-09-09 text/html https://www.dovepress.com/implementation-of-an-electronic-surgical-referral-service-collaboratio-peer-reviewed-fulltext-article-JMDH en eng Dove Press info:eu-repo/semantics/altIdentifier/doi/10.2147/JMDH.S66693 https://www.dovepress.com/implementation-of-an-electronic-surgical-referral-service-collaboratio-peer-reviewed-fulltext-article-JMDH info:eu-repo/semantics/openAccess Journal of Multidisciplinary Healthcare Original Research info:eu-repo/semantics/article 2014 ftdovepress https://doi.org/10.2147/JMDH.S66693 2022-12-27T21:45:36Z Knut Magne Augestad,1–3 Arthur Revhaug,1,3 Roar Johnsen,4 Stein-Olav Skrøvseth,2 Rolv-Ole Lindsetmo1,3 1Department of Gastrointestinal Surgery, 2Department of Integrated Care and Telemedicine, University Hospital North Norway, Tromsø, Norway; 3Department of Colorectal Surgery, University Hospitals Case Medical Center, Cleveland, Ohio, USA; 4Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway Background: Poor coordination between levels of care plays a central role in determining the quality and cost of health care. To improve patient coordination, systematic structures, guidelines, and processes for creating, transferring, and recognizing information are needed to facilitate referral routines. Methods: Prospective observational survey of implementation of electronic medical record (EMR)-supported guidelines for surgical treatment. Results: One university clinic, two local hospitals, 31 municipalities, and three EMR vendors participated in the implementation project. Surgical referral guidelines were developed using the Delphi method; 22 surgeons and seven general practitioners (GPs) needed 109 hours to reach consensus. Based on consensus guidelines, an electronic referral service supported by a clinical decision support system, fully integrated into the GPs' EMR, was developed. Fifty-five information technology personnel and 563 hours were needed (total cost 67,000 £) to implement a guideline supported system in the EMR for 139 GPs. Economical analyses from a hospital and societal perspective, showed that 504 (range 401–670) and 37 (range 29–49) referred patients, respectively, were needed to provide a cost-effective service. Conclusion: A considerable amount of resources were needed to reach consensus on the surgical referral guidelines. A structured approach by the Delphi method and close collaboration between IT personnel, surgeons and primary care physicians were needed to reach consensus. Keywords: hospital referrals, surgery, patient pathways, ... Article in Journal/Newspaper North Norway Tromsø Dove Medical Press Norway Tromsø Journal of Multidisciplinary Healthcare 371 |
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Journal of Multidisciplinary Healthcare |
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Journal of Multidisciplinary Healthcare Augestad,Knut Magne Revhaug,Arthur Johnsen,Roar Skrøvseth,Stein-Olav Lindsetmo,Rolv-Ole Implementation of an electronic surgical referral service. Collaboration, consensus and cost of the surgeon – general practitioner Delphi approach |
topic_facet |
Journal of Multidisciplinary Healthcare |
description |
Knut Magne Augestad,1–3 Arthur Revhaug,1,3 Roar Johnsen,4 Stein-Olav Skrøvseth,2 Rolv-Ole Lindsetmo1,3 1Department of Gastrointestinal Surgery, 2Department of Integrated Care and Telemedicine, University Hospital North Norway, Tromsø, Norway; 3Department of Colorectal Surgery, University Hospitals Case Medical Center, Cleveland, Ohio, USA; 4Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway Background: Poor coordination between levels of care plays a central role in determining the quality and cost of health care. To improve patient coordination, systematic structures, guidelines, and processes for creating, transferring, and recognizing information are needed to facilitate referral routines. Methods: Prospective observational survey of implementation of electronic medical record (EMR)-supported guidelines for surgical treatment. Results: One university clinic, two local hospitals, 31 municipalities, and three EMR vendors participated in the implementation project. Surgical referral guidelines were developed using the Delphi method; 22 surgeons and seven general practitioners (GPs) needed 109 hours to reach consensus. Based on consensus guidelines, an electronic referral service supported by a clinical decision support system, fully integrated into the GPs' EMR, was developed. Fifty-five information technology personnel and 563 hours were needed (total cost 67,000 £) to implement a guideline supported system in the EMR for 139 GPs. Economical analyses from a hospital and societal perspective, showed that 504 (range 401–670) and 37 (range 29–49) referred patients, respectively, were needed to provide a cost-effective service. Conclusion: A considerable amount of resources were needed to reach consensus on the surgical referral guidelines. A structured approach by the Delphi method and close collaboration between IT personnel, surgeons and primary care physicians were needed to reach consensus. Keywords: hospital referrals, surgery, patient pathways, ... |
format |
Article in Journal/Newspaper |
author |
Augestad,Knut Magne Revhaug,Arthur Johnsen,Roar Skrøvseth,Stein-Olav Lindsetmo,Rolv-Ole |
author_facet |
Augestad,Knut Magne Revhaug,Arthur Johnsen,Roar Skrøvseth,Stein-Olav Lindsetmo,Rolv-Ole |
author_sort |
Augestad,Knut Magne |
title |
Implementation of an electronic surgical referral service. Collaboration, consensus and cost of the surgeon – general practitioner Delphi approach |
title_short |
Implementation of an electronic surgical referral service. Collaboration, consensus and cost of the surgeon – general practitioner Delphi approach |
title_full |
Implementation of an electronic surgical referral service. Collaboration, consensus and cost of the surgeon – general practitioner Delphi approach |
title_fullStr |
Implementation of an electronic surgical referral service. Collaboration, consensus and cost of the surgeon – general practitioner Delphi approach |
title_full_unstemmed |
Implementation of an electronic surgical referral service. Collaboration, consensus and cost of the surgeon – general practitioner Delphi approach |
title_sort |
implementation of an electronic surgical referral service. collaboration, consensus and cost of the surgeon – general practitioner delphi approach |
publisher |
Dove Press |
publishDate |
2014 |
url |
https://www.dovepress.com/implementation-of-an-electronic-surgical-referral-service-collaboratio-peer-reviewed-fulltext-article-JMDH |
geographic |
Norway Tromsø |
geographic_facet |
Norway Tromsø |
genre |
North Norway Tromsø |
genre_facet |
North Norway Tromsø |
op_relation |
info:eu-repo/semantics/altIdentifier/doi/10.2147/JMDH.S66693 https://www.dovepress.com/implementation-of-an-electronic-surgical-referral-service-collaboratio-peer-reviewed-fulltext-article-JMDH |
op_rights |
info:eu-repo/semantics/openAccess |
op_doi |
https://doi.org/10.2147/JMDH.S66693 |
container_title |
Journal of Multidisciplinary Healthcare |
container_start_page |
371 |
_version_ |
1766140158778802176 |