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首页> 外文期刊>JMIR Medical Informatics >A Data Model for Teleconsultation in Managing High-Risk Pregnancies: Design and Preliminary Evaluation
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A Data Model for Teleconsultation in Managing High-Risk Pregnancies: Design and Preliminary Evaluation

机译：远程咨询管理高危妊娠的数据模型：设计和初步评估

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Background Teleconsultation is a guarantor for virtual supervision of clinical professors on clinical decisions made by medical residents in teaching hospitals. Type, format, volume, and quality of exchanged information have a great influence on the quality of remote clinical decisions or tele-decisions. Thus, it is necessary to develop a reliable and standard model for these clinical relationships. Objective The goal of this study was to design and evaluate a data model for teleconsultation in the management of high-risk pregnancies. Methods This study was implemented in three phases. In the first phase, a systematic review, a qualitative study, and a Delphi approach were done in selected teaching hospitals. Systematic extraction and localization of diagnostic items to develop the tele-decision clinical archetypes were performed as the second phase. Finally, the developed model was evaluated using predefined consultation scenarios. Results Our review study has shown that present medical consultations have no specific structure or template for patient information exchange. Furthermore, there are many challenges in the remote medical decision-making process, and some of them are related to the lack of the mentioned structure. The evaluation phase of our research has shown that data quality ( P <.001), adequacy ( P <.001), organization ( P <.001), confidence ( P <.001), and convenience ( P <.001) had more scores in archetype-based consultation scenarios compared with routine-based ones. Conclusions Our archetype-based model could acquire better and higher scores in the data quality, adequacy, organization, confidence, and convenience dimensions than ones with routine scenarios. It is probable that the suggested archetype-based teleconsultation model may improve the quality of physician-physician remote medical consultations.
机译：背景技术远程咨询是对临床教授进行虚拟监督的保证人，以指导教学医院的医疗居民做出的临床决策。交换信息的类型，格式，数量和质量对远程临床决策或远程决策的质量有很大影响。因此，有必要为这些临床关系建立可靠的标准模型。目的本研究的目的是设计和评估远程咨询在高危妊娠管理中的数据模型。方法本研究分三个阶段进行。在第一阶段，在选定的教学医院进行了系统的回顾，定性研究和德尔菲方法。第二阶段是对诊断项目进行系统提取和定位以发展远程决策临床原型。最后，使用预定义的咨询方案评估了开发的模型。结果我们的回顾研究表明，目前的医疗咨询没有用于患者信息交流的特定结构或模板。此外，远程医疗决策过程中存在许多挑战，其中一些与缺乏上述结构有关。我们研究的评估阶段表明，数据质量（P <.001），充足性（P <.001），组织（P <.001），置信度（P <.001）和便利性（P <.001）与基于常规的咨询方案相比，基于原型的咨询方案得分更高。结论我们的基于原型的模型在数据质量，充分性，组织性，置信度和便利性方面的得分比常规方案更高且更高。建议的基于原型的远程咨询模型可能会提高医师-医师远程医疗咨询的质量。

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