Informatization of healthcare
  • 2023 № 4 The possibilities of redistributing the functions of the city clinic at the opening of the Distant consultation center unit.

    Goal. To evaluate the interim results of a pilot project on the organization of an independent unit of a city clinic that provides remote support to citizens – the Distant Consultation Center of the Government Autonomous Organization Healthcare “City Clinic No. 8” (hereinafter referred to as the DCC).
    M e t h o d s o f w o r k . To assess the effectiveness of the pilot project, a number of indicators of the work of the medical organization were analyzed before the start of the project and 12 months after the start of its implementation. The analysis was carried out in two way of work of the Distant Consultation Center: 1. the process of providing medical care to patients with acute respiratory viral infections / Influenza / COVID‑19; 2. the process of providing medicines to the Subsidized category of citizens. The volumes of work that can be transferred to the Distant Consultation Center
    from the department of primary care physicians care and from the emergency medical care are analyzed.
    The source of the data was the medical information system of the medical organization “URMO TO” (modules Registry, Control of realization, doctor’s ARM, Disability sheets, Additional processing). The period of work of the medical organization from 01.01.2022 to 31.12.2022 is analyzed.
    Statistical processing of the results was carried out using the Statistica 6.0 application software package.
    Distance consultation was carried out via IP telephony, as well as using specialized Telemedicine software.
    R e s u l t s o f t h e w o r k . Before the organization of the DCC, the median indicator of the actual workload per hour of the covid team was 2,5 [2,3–2,7] patients, p<0,07. While the doctor of DCC carried out an average of 56,9 [44–68] remote consultations, which is an average of 8,8 patients per hour, p< 0,07.
    The median value of patients for prescriptions for Subsidized medicines before the start of the project was 4 [3–6] patients per day (p<0,07), on average 22.2% time of the initial consultation falls on patients requiring a Subsidized medicine. The median value of applications for the purpose of providing Subsidized categories of citizens with medicines when discharged by a medical assistant at the DCC was 1 [0–3] (p<0,08). Thus, this section began to occupy 0,06% in the structure of reasons for the initial appointment to the primary care physician.
    C o n c l u s i o n s . The organization of the work of the DCC allowed us to develop approaches, approve and adapt them to the processes of filling out the schedule of primary care doctors in order to increase accessibility to the primary consultations of the primary care physician’s department.
    Scaling up the organizational model and processes of the Distance consultation center of the Municipal Polyclinic No. 8 can serve as an effective tool in achieving the goals announced within the framework of the pilot project of the Ministry of Health of the Russian Federation “Incident 38” launched in 2022.
    T h e s c o p e o f t h e r e s u l t s . The presented experience shows the possibility of managing patients with respiratory viral diseases in outpatient polyclinic conditions on an ongoing basis, as well as the telemedicine format of care can be extended and adapted to non-infectious nosologies.

    Authors: Nemkov A. G. [3] Smolyarenko A. M. [1] Grekhneva M. V. [1] Matyushkina E. A. [1]

    Tags: covid-1928 distance consultation center1 outpatient polyclinic service1 telemedicine consultations1 telemedicine technologies3 “incident 38”1

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