Identification of indicators used to assess needs for telemedicine consultations in various profiles of medical care

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BACKGROUND: A unified system for assessing the results and real contributions of telemedicine consultations to improving medical care quality in the healthcare system of the Russian Federation has not yet been developed.

AIM: To develop a system of indicators for differentiated assessment of the needs for telemedicine consultations in the provision of medical care.

MATERIALS AND METHODS: In the first stage, reports on the results of on-site activities of national medical research centers in regions of the Russian Federation and their annual public reports (2020–2022) were analyzed to identify indicators that determine the need for telemedicine consultations. The identified indicators were clarified and validated in an open interview with the representatives of the national medical research centers. In the second stage, the value of each indicator was determined based on the expert survey: 18 experts assessed each indicator on a scale of 1–5. Then, the weight coefficient of each indicator was calculated for their subsequent use in planning the coverage of telemedicine consultations.

RESULTS: Three groups of indicators that determined the need for telemedicine consultations for different medical care profiles were as follows: (1) indicators that affect the planned volumes of telemedicine consultations, (2) indicators that characterize the efficiency and effectiveness of telemedicine consultations, and (3) indicators that characterize the validity of requests for telemedicine consultations. Group 1 included indicators of lethality, disability, hospital mortality, frequency of emergency/urgent consultations, and frequency of consultations of patients requiring intensive care. Group 2 included indicators for assessing the effectiveness and efficiency of telemedicine consultations, both subjective (result satisfaction) and objective (number of positive and negative treatment and hospitalization outcomes for cases that received where telemedicine consultations). Group 3 included indicators that characterize the validity of requests for telemedicine consultations: thoroughness of a patient’s examination before a telemedicine consultation and accuracy of the diagnosis. The weight coefficients of group 1 indicators ranged from 0.05 to 1.61 and varied for different profiles.

CONCLUSION: A system of indicators was proposed for the differentiated assessment of the needs for telemedicine consultations when providing medical care.

About the authors

Elena S. Samsonova

The Center for Healthcare Quality Assessment and Control; N.A. Semashko National Research Institute of Public Health; Russian Medical Academy of Continuous Professional Education

Email: samsonova@rosmedex.ru
ORCID iD: 0000-0002-6085-1320
SPIN-code: 8372-5195
Russian Federation, Moscow; Moscow; Moscow

Ilya A. Mikhailov

The Center for Healthcare Quality Assessment and Control; N.A. Semashko National Research Institute of Public Health; Russian Medical Academy of Continuous Professional Education

Author for correspondence.
Email: mikhailov@rosmedex.ru
ORCID iD: 0000-0001-8020-369X
SPIN-code: 5798-0749
Scopus Author ID: 57203900904
ResearcherId: I-9035-2017

MD, Cand. Sci. (Medicine)

Russian Federation, Moscow; Moscow; Moscow

Vitaly V. Omelyanovsky

The Center for Healthcare Quality Assessment and Control; N.A. Semashko National Research Institute of Public Health; Russian Medical Academy of Continuous Professional Education; Scientific and research financial institute

Email: vvo@rosmedex.ru
ORCID iD: 0000-0003-1581-0703
SPIN-code: 1776-4270

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Moscow; Moscow; Moscow; Moscow

Maria V. Avksentieva

The Center for Healthcare Quality Assessment and Control; Russian Medical Academy of Continuous Professional Education

Email: avksenteva@rosmedex.ru
ORCID iD: 0000-0001-6660-0402
SPIN-code: 3333-4237

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Moscow; Moscow

Inna A. Zheleznyakova

The Center for Healthcare Quality Assessment and Control; Russian Medical Academy of Continuous Professional Education

Email: zheleznyakova@rosmedex.ru
ORCID iD: 0000-0003-2943-6564
SPIN-code: 2413-9265
Russian Federation, Moscow; Moscow

Georgy G. Lebedenko

The Center for Healthcare Quality Assessment and Control; Russian Medical Academy of Continuous Professional Education

Email: lebedenko@rosmedex.ru
SPIN-code: 5504-7272
Russian Federation, Moscow; Moscow

References

  1. Hsu M-H, Chu T-B, Yen J-C, et al. Development and implementation of a national telehealth project for long-term care: a preliminary study. Computer methods and programs in biomedicine. 2010;97(3):286–292. doi: 10.1016/j.cmpb.2009.12.008
  2. Telemedicine Consultations for Patients in Long Term Care: A Review of Clinical Effectiveness, Cost-Effectiveness, and Guidelines. Ottawa: Canadian Agency for Drugs and Technologies in Health; 2015.
  3. Kern-Goldberger AR, Srinivas SK. Telemedicine in Obstetrics. Clinics in perinatology. 2020;47(4):743–757. doi: 10.1016/j.clp.2020.08.007
  4. Narasimha S, Madathil KC, Agnisarman S, et al. Designing Telemedicine Systems for Geriatric Patients: A Review of the Usability Studies. Telemedicine journal and e-health. 2017;23(6):459–472. doi: 10.1089/tmj.2016.0178
  5. Wolf TG, Schulze RKW, Ramos-Gomez F, et al. Effectiveness of Telemedicine and Teledentistry after the COVID-19 Pandemic. International journal of environmental research and public health. 2022;19(21). doi: 10.3390/ijerph192113857
  6. Omboni S, McManus RJ, Bosworth HB, et al. Evidence and Recommendations on the Use of Telemedicine for the Management of Arterial Hypertension: An International Expert Position Paper. Hypertension. 2020;76:1368–1383. doi: 10.1161/HYPERTENSIONAHA.120.15873
  7. Chirra M, Marsili L, Wattley L, et al. Telemedicine in Neurological Disorders: Opportunities and Challenges. Telemedicine journal and e-health: the official journal of the American Telemedicine Association. 2019;25(7):541–550. doi: 10.1089/tmj.2018.0101
  8. Jackson LE, Edgil TA, Hill B, et al. Telemedicine in rheumatology care: A systematic review. Seminars in arthritis and rheumatism. 2022;56:152045. doi: 10.1016/j.semarthrit.2022.152045
  9. Rubin MN, Demaerschalk BM. The use of telemedicine in the management of acute stroke. Neurosurgical focus. 2014;36(1):E4. doi: 10.3171/2013.11.FOCUS13428
  10. Drapkina OM, Shepel RN, Vakhovskaya TV, et al. Evaluation of the effectiveness of telemedicine consultations conducted by experts of National Medical Research Center for Therapy and Preventive Medicine. Profilakticheskaya Meditsina. 2020;23(6):7–14. doi: 10.17116/profmed2020230617
  11. Chekhonadsky II, Skripov VS, Semenova NV, Shvedova AA, Malyshko LV. Capabilities of telemedicine consultations of patients with mental disorders. Profilakticheskaya Meditsina. 2021;24(9):74–78. doi: 10.17116/profmed20212409174
  12. Skripov VS, Chekhonadsky II, Kochorova LV, Shvedova AA, Semenova NV. Results of interaction with regional services in the framework of telemedicine consultations on psychiatry and narcology. V.M. Bekhterev review of psychiatry and medical psychology. 2019;(3):73–77. doi: 10.31363/2313-7053-2019-3-73-77
  13. Skripov VS, Semenova NV, Kochorova LV, Shvedova AA, Chekhonadsky II. Experience in consulting with the use of telemedicine technologies in psychiatry and narcology. Bulletin of the Russian military medical academy. 2019;2(66):188–190.
  14. Chukhrayov AM, Khodzhaev NS, Kechin EV. Analysis of the structure of telemedicine consultations in ophthalmology in the Russian Federation. Health care of the Russian Federation. 2020;64(1):22–28. doi: 10.18821/0044-197X-2020-64-1-22-28
  15. Potievskaya VI, Kononova EV, Shaputko NV, et al. Telehealth consultations in cardio-oncology. Cardiovascular Therapy and Prevention. 2022;21(2):60–71. doi: 10.15829/1728-8800-2022-3164
  16. Gautier SV, Khomyakov SM. Planning of remote consultations with the use of telemedicine technologies on the profile “transplantation”. Russian Journal of Transplantology and Artificial Organs. 2019;21(S):9–10. (In Russ).
  17. Pyregov AV, Kholin AM, Yurova MV, Khamo AA. Analysis of the effectiveness of telemedicine consultations in obstetrics in the profile “Anesthesiology and resuscitation” on the example of two-year experience of the National Research Center. Akusherstvo i ginekologiya. 2020(1):155–162. (In Russ). doi: 10.18565/aig.2020.1.155-162
  18. Sukhikh GT, Shuvalova MP, Kan NE, Prialukhin IA. The role of the National Medical Research Center in the quality and safety of maternity services in the regions of the Russian Federation. Vestnik Roszdravnadzora. 2023;(1):20–27.
  19. Alekseeva NYu, Rudenko NYu, Syagaev RA. Analysis of the use of telemedicine technologies in the provision of medical care to the pediatric population of the Irkutsk region. Sistema menedzhmenta kachestva: opyt i perspektivy. 2022;(11):266–269. (In Russ).
  20. Gorshkov MK, Sheregi FE. Applied Sociology: Methodology and Methods. Moscow: Al’fa-M: INFRA-M; 2009. (In Russ).
  21. Willerman B. The adaptation and use of Kendall’s coefficient of concordance (W) to sociometric-type rankings. Psychol Bull. 1955;52(2):132–133. doi: 10.1037/h0041665
  22. Khanal S, Burgon J, Leonard S, et al. Recommendations for the Improved Effectiveness and Reporting of Telemedicine Programs in Developing Countries: Results of a Systematic Literature Review. Telemedicine journal and e-health. 2015;21(11):903–915. doi: 10.1089/tmj.2014.0194
  23. Alami H, Gagnon MP, Wootton R, Fortin JP, Zanaboni P. Exploring factors associated with the uneven utilization of telemedicine in Norway: a mixed methods study. BMC medical informatics and decision making. 2017;17(1):180. doi: 10.1186/s12911-017-0576-4

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2. Fig. 1. Four medical care profiles with maximum values ​​of weighting coefficients of indicators influencing the planned volumes of telemedicine consultations.

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