| Up to now, primary assistance doctors asked specialists for opinions on specific cases in informal meetings in hospital corridors or even in the cafeteria. Many patients were therefore sent on to a consultant in a manner that was not well coordinated, sometimes unnecessarily and at a cost that could have been saved. Electronic queries or eQueries, a new application of ICTs in the health area, resolves these problems and improves the quality of the reply. The North American Commonwealth Fund recently studied the experience of the pioneers in eQuery. |
The eQuery is specifically an emerging ICT
tool that enables asynchronous electronic communication between the
family GPs and consultants on general or specific questions
concerning their patients. E-mail is the most
basic form of eQuery, although computer
applications have been developed to combine the
shared electronic medical record and
instant messaging or web based
platforms. The shared objective of these tools is to
prevent bad practice and to save in time and cost.
In fact, The Commonwealth Fund estimates that 65% of patients
passed on by traditional methods are done so inappropriately, and
that the impact of this is negative with regard to the experience
of patients, who are unaware of the errors in the coordination
between the doctors attending them.
The eQuery is therefore presented as a strategy for facing
the new challenges in a context marked by the ageing
population and the increase in chronic illness. It is also intended
to improve communication and coordination between health
professionals. In any case, it is important for doctors to
follow standard procedures in order to maximise the
benefits and use shared resources such as the EMR
to speed up the process. Once the question has been made
electronically, the consulted doctor can answer directly, ask for
further information on the case on which to base their answer, or
formally ask the requesting doctors to allow them to see the
patient, which means that the patient has to be referred.
However, the potential of the eQuery depends on the medical
speciality. It will be more useful for cases requiring a
cognitive approach and will not be so satisfactory for
anyone requiring technical advice. The specialities based on lab
tests such as endocrinology or
nephrology may become potential users of the
eQuery, and also geriatrics or
rheumatology. On the other hand, doctors
specialised in procedures, such as gastroenterologists or
cardiologists, will find it more difficult to adapt.
In any case, both doctors and patients and the whole health system
benefit from the use of eQueries: it improves the
attention, documentation, access to specialists and transfer of
information. Nevertheless, to make it extensive it is
necessary to continue to implement ICTs in the health centres and
to bring in incentives for health professionals.
Bibliographical reference
Horner, K, [et al.]. Electronic Consultations Between Primary and
Specialty Care Clinicians: Early Insights. Issue Brief. The
Commonwealth Fund. October 2011 [access 3 January 2012]. Available
at:
http://www.commonwealthfund.org/~/media/Files/Publications/Issue%20Brief/2011/Oct/1554_Horner_econsultations_primary_specialty_care_clinicians_ib.pdf
