Objective To explore the consultation model of multi-disciplinary team （MDT） for colorectal cancer (CRC). Methods Combined the characteristics of large public hospital, with recognized treatment pathway in international MDT for CRC and a comparison to the traditional consultation, to explore a consultation process model of multi-disciplinary team-working for colorectal cancer of West China Hospital (MDT-CRC-WCH) by own feature. Results Colorectal cancer MDT project team summarized the advantage of the consultation process of MDT-CRC-WCH and the drawback of the traditional consultation, descripted the purpose and characterisctics of MDT consultation by adopting creative whole-mode ideal of MDT-CRC-WCH, and descripted the present implementation of the consultation of MDT-CRC-WCH. Conclusion The consultation process of MDT has appeared distinctive features to the traditional, and it may direct the future evolving of the consultation model, however, advanced research is needed.
Objective To review published literature on telemedicine in China using qualitative analysis. Methods Such databases as CBM, VIP, CNKI, and CSSCI were electronically and comprehensively searched for clinical studies related to telemedicine from inception to March 2013. References of the included studies were also retrieved. Two reviewers independently identified the literature according to inclusion and exclusion criteria, extracted data, and assessed the quality of the included studies. Then, qualitative analysis was performed in aspects of the application fields, range, and effects of the included studies. Result Finally, 19 studies were eligible for the analysis, including 16 quasi-randomized controlled trials and 3 observational studies. According to methodological evaluation standards (JBI, 2005), among 16 quasi-randomized controlled trials, 12 were of medium quality and four were of low quality; and 3 observational studies were all of low quality. The results of qualitative analysis showed that, literature on telemedicine had increased by year since 1995. However, the literature on relevant research of telemedicine had been published since 2002. The number of literature increased evenly and sporadically in journals. According to the classification of the application fields of telemedicine, 15 (80%) related to remote monitoring, especially related to remote fetal monitoring, 4 (21%) were remote consultation, and 3 (16%) were remote treatment. The results of 19 studies showed that, telemedicine had better effects than traditional medicine. Conclusion In China, literature related to telemedicine increases by year but the quality of them are low. High quality studies are further needed. The distribution of the application fields of telemedicine is uneven, most of which focuses on remote monitoring. The quality of research is low and need high-quality research in future. The therapeutic effects of telemedicine are better with accurate monitoring data and convenience to patients..
ObjectiveTo discuss the practical methods of clinical drug therapy with clinical pharmacists' participation. MethodThe patient was male and at the age of 88. Because of "exertional heart tiredness for 4 years, coughing sputum for 10 days, and sudden inarticulate condition", he was admitted into the hospital on November 22nd, 2013. The diagnosis was cerebral infarction with pulmonary infection. Clinical pharmacists participated in the consultation on February 19th, 2014 because the uncontrollable repeated pulmonary infection. By analyzing the therapeutic scheme, clinical pharmacists made and adjusted the treatment scheme for one patient with refractory infections. ResultsAfter the treatment scheme was adjusted, several laboratory test results of the patient returned to normal, including respiratory rate, body temperature, white blood cell count and neutrophils. Sputum volume decreased obviously and sputum culture was negative. Lung signs and image were significantly improved. ConclusionsClinical pharmacists should pay more attention to the analysis of the clinical therapeutic scheme to improve therapeutic efficacy for patients with refractory infections.
Objective To improve the satisfaction of standardized remote consultation of epilepsy center in patients with refractory epilepsy, and initially establish a standardized remote consultation model of three-level comprehensive epilepsy center. Methods Based on the characteristics of our epilepsy center, we designed a set of standardized remote consultation process of epilepsy center in tertiary hospitals, including sorting out patient data before consultation, improving examination, application of multi-modal technology during consultation, notification of results after consultation, and decision of operation time and method. A total of 209 patients who received remote consultation in our epilepsy center from January 2022 to June 2023 were selected as the observation group, and 150 patients who received offline consultation in our epilepsy center during the same period were randomly selected as the control group. The satisfaction of patients in the two groups on the service of doctors and nurses in consultation and the consultation results were compared. Results Through the application of the new multi-modal remote consultation mode, the number of consultations gradually increased, Compared with the offline consultation mode, there was no significant difference in patients' satisfaction with the service of doctors and nurses in remote consultation mode (P<0.05). Conclusion The establishment of standardized remote consultation mode in epilepsy center has effectively reduced the economic burden of patients, simplified the medical treatment process and improved the service quality, but the consultation quality has not been affected.
Consultation is an important form for the diagnosis and treatment of severe diseases, and consultation management is an important content of medical management work, which directly affects the medical quality and treatment efficiency of the hospital. With the help of information network platform, our hospital has realized electronic consultation system online through scientific development, training enhancement, and safeguard mechanism improvement. The system can optimize consultation work process effectively, improve the consultation work, save manpower cost and help construction of hospital informatization.
ObjectiveTo observe the demographic data, disease composition and convenience of remote consultation in ophthalmology. MethodsA retrospective study. From 2015 to 2021, the demographic data, changing trends, disease classification of teleconsultation patients, and hospitals participating in teleconsultation, and the waiting time of patients for teleconsultation was analyzed retrospectively; remote consultation physician level composition and other data was analyzed. ResultsDuring the 7-year period, 1 216 patients with remote consultation were obtained through the platform of the telemedicine center. Among them, there were 680 males and 536 females; the average age was 50.8 years. In 2016 and 2017, the number of patients participating in telemedicine consultations reached a peak of 260 and 221 cases, respectively. Among the ophthalmic diseases, there were 490 cases (40.30%, 490/1 216) of retinal and optic nerve-related diseases, 212 cases (17.43%, 212/1 216) of ocular trauma. 678 cases (56.27%, 678/1 205) of remote consultation waiting time were less than 24 hours, 991 cases (82.24%, 991/1 205) were less than 48 hours. Among the physicians who participated in the remote consultation, there were 733 chief physicians (60.3%, 733/1 216) and 466 deputy chief physicians (38.3%, 466/1 216). ConclusionsDuring the seven-year period from 2015 to 2021, there are relatively few patients with ophthalmology teleconsultation; retinal and optic nerve-related diseases accounted for a high proportion. Remote consultation has high convenience.