Article type
Abstract
Background: Access to specialized care remains a problem for public and universal healthcare systems. Teleconsulting, the use of technologies to provide specialized guidance to primary health care (PHC) professionals, can overcome this challenge.
Objective: To map the evidence available in the literature and identify the best experiences regarding the use of teleconsulting as a strategy to support clinical decisions in PHC.
Methods: This is a scoping review guided by the structure proposed by Arksey & O'Malley and following the guidelines of the Joanna Briggs Institute (JBI) and PRISMA-ScR (The Preferred Reporting Items for Systematic reviews and Meta-Analyses Extension for Scoping reviews). The MEDLINE databases were consulted via PUBMED, EMBASE, Cochrane Library and LILACS via BVSalud. There were no language or publication date restrictions. The study inclusion criteria were listed based on the acronym PCC, in which, the (P) Population are primary health care professionals; o (C) Key concept is teleconsulting as a strategy to support clinical decisions for primary health care professionals and o (C) Context is public health systems in any region or country. Data from the included publications were retrieved and synthesized.
Results: The search resulted in a total of 3,932 works. Of these studies, 182 were included in the review. The results showed that the tools used to carry out teleconsulting range from simple tools such as telephone calls, smartphones and video conferencing, to electronic platform systems. Publications were found in 19 countries for 27 different medical specialties. The two countries with the highest number of publications were Brazil and Canada.
Conclusion: The experiences showed benefits for health systems in the use of teleconsultation in reducing the time for access to specialized care by patients treated in PHC, while also qualifying in-person referrals of these patients to secondary care. The main barriers were the inadequacy of responses to teleconsultation requests, infrastructure problems, difficulty in incorporating the program into the organizational culture and the lack of management support. Cost reduction for the system and user satisfaction with teleconsulting were highlighted as main strengths.
Objective: To map the evidence available in the literature and identify the best experiences regarding the use of teleconsulting as a strategy to support clinical decisions in PHC.
Methods: This is a scoping review guided by the structure proposed by Arksey & O'Malley and following the guidelines of the Joanna Briggs Institute (JBI) and PRISMA-ScR (The Preferred Reporting Items for Systematic reviews and Meta-Analyses Extension for Scoping reviews). The MEDLINE databases were consulted via PUBMED, EMBASE, Cochrane Library and LILACS via BVSalud. There were no language or publication date restrictions. The study inclusion criteria were listed based on the acronym PCC, in which, the (P) Population are primary health care professionals; o (C) Key concept is teleconsulting as a strategy to support clinical decisions for primary health care professionals and o (C) Context is public health systems in any region or country. Data from the included publications were retrieved and synthesized.
Results: The search resulted in a total of 3,932 works. Of these studies, 182 were included in the review. The results showed that the tools used to carry out teleconsulting range from simple tools such as telephone calls, smartphones and video conferencing, to electronic platform systems. Publications were found in 19 countries for 27 different medical specialties. The two countries with the highest number of publications were Brazil and Canada.
Conclusion: The experiences showed benefits for health systems in the use of teleconsultation in reducing the time for access to specialized care by patients treated in PHC, while also qualifying in-person referrals of these patients to secondary care. The main barriers were the inadequacy of responses to teleconsultation requests, infrastructure problems, difficulty in incorporating the program into the organizational culture and the lack of management support. Cost reduction for the system and user satisfaction with teleconsulting were highlighted as main strengths.