2019 HSC Section 2 - Practice Management

III. Communication A. Communication tools for physicians & patients

Lee JL, Choudhry NK, Wu AW, et al. Patient use of email, Facebook, and physician websites to communicate with physicians: a national online survey of retail pharmacy users. J Gen Intern Med . 2016; 31(1):45-51. EBM level 4................................................................................106-112 Summary : A survey was conducted of a cross-section of patients to look at patient behavior and interest in using the internet to contact their physicians. Specifically, use of email and Facebook both were studied. The authors report that 90% of adults in the US use the internet and 72% visit social media sites such as Facebook, with 12% using social media to research health topics. Older patients were less likely to use the internet to contact their physicians. Patients have interest in web-based tools but are not fully utilizing those tools. B. Telehealth Kohlert S, Murphy P, Tse D, et al. Improving access to otolaryngology-head and neck surgery expert advice through eConsultations. Laryngoscope. 2018; 128(2):350-355. EBM level 4....................................................................................................................................113-118 Summary : An eConsult can be an option for a referring provider to access specialists with clinical questions in an asynchronous fashion. The study reviews the eConsult process experience at a Canadian institution, showing the potential benefits of reduced wait times, improved communication between referring and otolaryngology providers, and targeted professional development efforts. Seim NB, Philips RHW, Matrka LA, et al. Developing a synchronous otolaryngology telemedicine clinic: prospective study to assess fidelity and diagnostic concordance. Laryngoscope . 2018; 128(5):1068-1074. EBM level 2.......................................................119-125 Summary : Telemedicine serves to provide remote access to medical care in underserved locations. The authors explore the potential for this technology in otolaryngology, as well as attempt to compare results from a synchronous in-person and telemedicine examination. Murray N, Valdez TA, Hughes AL, Kavanagh KR. Teaching a tracheotomy handoff tool to pediatric first responders. Int J Pediatr Otorhinolaryngol . 2018; 114:120-123. EBM level 4....................................................................................................................................126-129 Summary : The goal of this study was to determine the reliability of teaching and ease of learning the CARE system (Critical Airway Risk Evaluation for difficulty of intubation in pediatric tracheostomy patients) for pediatric otolaryngologists and otolaryngology and pediatric residents. A tutorial was designed to teach the CARE system, as well as an overview on airway anatomy and tracheotomy tubes. An immediate posttest was conducted. There was no difference between pediatric and otolaryngology residents’ airway identifications, and there was substantial interrater reliability among all groups. This may aid in the hand-offs or transitions of care in pediatric tracheostomy patients.

IV. Systems-Based Practice A. Transitions in care