%0期刊文章%@ 1438- 8871% I JMIR出版物%V 20卡塔尔世界杯8强波胆分析% N 4% P e124% T优化初级保健提供者和精神科医生之间的电子咨询:混合方法研究%A Hensel,Jennifer M %A Yang,Rebecca %A Rai,Minnie %A Taylor,Valerie H %+女子学院医院医疗解决方案和虚拟护理研究所，女子学院医院，76 Grenville St，多伦多，ON, M5S 1B2，加拿大，1 416 323 6230,jennifer.hensel@wchospital.ca %K eHealth %K精神病学%K初级保健%K咨询%K卫生服务%D 2018年%7 06.04.2018 %9原始论文%J J医学互联网Res %G英文%X背景:鉴于初级保健中精神健康问题的高患病率和获得专家护理的问题，初级保健提供者和精神病医生之间使用电子会诊(e-会诊)具有潜力。然而，利用和吸收似乎比预期的要低。目的:本研究旨在调查pcp和精神科医生之间电子会诊的实际使用情况，并调查pcp对这种精神科咨询形式的看法，以告知如何优化效用，从而吸收这项服务。方法:在这项混合方法研究中，我们对加拿大安大略省早期实施的2个平台上的精神病学电子咨询(N=37)进行了图表回顾，以及对不同经验水平和不同实践环境的pcp (N=10)进行了3次小组访谈和1次单独访谈。图表回顾评估了响应时间和转诊内容，包括请求类型、转诊附件和咨询师的答复。访谈探讨了pcp对精神病学电子会诊的使用和障碍的看法。对访谈数据的主题内容分析确定了常见主题以及不同提供者概况所特有的主题(例如，经验丰富的pcp vs新的pcp以及农村与城市实践)。在定量和定性结果解释的基础上，我们提出了优化精神病学电子会诊服务的建议。 Results: During the study period, psychiatry e-consults comprised 3.66% (49/1339) of all e-consults submitted on the studied platforms. Among the e-consults reviewed, different psychiatric diagnoses were represented: 70% of requests (26/37) queried about medication safety or side effects, whereas 59% (22/37) asked about psychiatric symptom management. Moreover, 81% (30/37) of e-consults were answered within 24 hours, and 65% (24/37) were addressed in a single exchange. Themes from the interview data included psychiatry having a complexity that differentiates it from other specialties and may limit the utility of e-consult, other than for psychopharmacology advice. Variability in awareness exists in the way e-consultation could be used in psychiatry, with new PCPs feeling unsure about the appropriateness of a question. In general, new PCPs and PCPs practicing in rural areas were more receptive to psychiatry e-consult. PCPs viewed e-consult as an opportunity to collaborate and desired that it be integrated with other available services. Recommendations include the need for appropriate specialist staffing to address a wide range of requests, adequate education to referrers regarding the use of psychiatry e-consult, and the need to integrate psychiatry e-consult with other geographically relevant services, given the complexity of psychiatric issues. Conclusions: E-consult is a viable and timely way for PCPs to get much-needed psychiatric advice. For optimizing its utility and uptake, e-consult needs to be integrated into reliable care pathways with adequate referrer and consultant preparation. %M 29625949 %R 10.2196/jmir.8943 %U //www.mybigtv.com/2018/4/e124/ %U https://doi.org/10.2196/jmir.8943 %U http://www.ncbi.nlm.nih.gov/pubmed/29625949