A Web-based consultation system between family physicians and nephrologists has the potential to reduce the number of referrals and appears to improve treatment appropriateness among patients with chronic kidney disease.
Analyzing 122 telenephrology consultations involving 116 patients, researchers found that in the absence of telenephrology, 43 patients (35 percent) would have been referred by their family physicians, whereas the nephrologist considered referral necessary in only 17 patients (14 percent) – an 84 percent reduction.
The opposite was seen in 10 patients, who according to clinicians could be treated in primary care but for whom the nephrologist deemed referral necessary.
The researchers note the time investment per consultation, most of which were performed during office hours, amounted to less than 10 minutes, and nephrologists' average response time was 1.6 days. The authors assert these findings support the introduction of telenephrology in primary care as a means of delivering higher quality, more convenient care at a lower cost.
They conclude that on a broader scale, e-consultation has the potential to break down walls between primary and specialty care.
Initial Implementation of a Web-Based Consultation Process for Patients w\With Chronic Kidney Disease.By Nynke Scherpbier-de Haan, MD, et al, Radboud University Nijmegen Medical Centre, The Netherlands