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Journal Article > Review
Patient safety risks associated with telecare: a systematic review and narrative synthesis of the literature.
Guise V, Anderson J, Wiig S. BMC Health Serv Res. 2014;14:588.
Patient safety in the homecare setting has begun to garner increasing attention. This systematic review explored patient safety issues related to the emerging use of telecare to provide remote services for patients at home. Many risks were identified, but the authors conclude more study is needed to understand telecare-related patient safety.
Community-based health coaches and care coordinators reduce readmissions using information technology to identify and support at-risk Medicare patients after discharge.
Agency for Healthcare Research and Quality. Health Care Innovations Exchange. July 30, 2014.
This article describes an intervention that trained health coaches to use mobile technology to assess the health status of recently discharged Medicare patients, first during an in-home visit 48 hours after leaving the hospital and then with weekly phone calls over a 3-week period. The program resulted in decreased readmission rates and significant cost savings.
Journal Article > Study
Is computer-assisted telephone triage safe? A prospective surveillance study in walk-in patients with non-life-threatening medical conditions.
Meer A, Gwerder T, Duembgen L, Zumbrunnen N, Zimmermann H. Emerg Med J. 2012;29:124-128.
This study compared assessments of hospital physicians, primary care physicians, and call center nurses in evaluating the acuity of patients who required telephone triage. Although agreement between clinicians was low, the incidence of potential patient harm was minimal.
Journal Article > Study
Katz HP, Kaltsounis D, Halloran L, Mondor M. J Gen Intern Med. 2008;23:517-522.
Telephone communication with patients is common in ambulatory practice, but accurately gauging illness severity and formulating an appropriate plan of action may be difficult, leading to potential patient safety issues. This study analyzed telephone-related closed malpractice claims from a large insurance company database in order to elucidate specific types of errors and contributing factors. Most cases alleged that clinicians failed to accurately diagnose the patient; types of errors leading to misdiagnosis included inadequate documentation, faulty triage, and lack of protocols for handling telephone calls. A diagnostic error due to faulty telephone triage is discussed in this AHRQ WebM&M case, and a prior commentary offers practical tips for improving patient triage and management by telephone.
Cases & Commentaries
- Spotlight Case
- Web M&M
Ronald L. Arenson, MD; March 2006
A patient with metastatic cancer admitted for pain control develops acute shortness of breath. The overnight resident reads the CT as a large pulmonary embolism, but the next morning, the attending reads it differently.