Medical teleconsultation to general practitioners reduces the medical error vulnerability of internal medicine patients

Background: e-Health strategies are supposed to improve the performance of national health systems. Medical teleconsultation (MT) is an important component of such e-Health strategies. Objectives: The outcome ofMTwas evaluated with regard to the impact on the medical error vulnerability (MEV) of internal medicine patients. Methods: A teamof internalmedicine doctors plus a network of forty specialistswas set-up in one health district belonging to a unified and universal national health system of a country of Western Europe, in order to provide free-of-charge MT to support general practitioners in solving internal medicine cases. In this observational study, the case series of 2013 is reviewed. Results: a) Only 21% of the MT fell short to the general practitioner's expectations about the case solving focus; b) throughout the medical care process of the patient, 49% of the cases met with one or more of the five MEVs, namely: 1) clinical test mishandling; 2) inaccurate differential diagnosis; 3) inadequate information flow between health providers at different levels of care (transition care); 4) poor coordination between health providers; and 5) poor reconciliation of medications or hazardous therapies. c) MT canceled or prevented MEVs in 56% and mitigateMEVs in 15% of the cases; d) MT canceled or prevented 85% ofMEV caused by poor information exchange in transition care, therefore improving patient referral and counter-referral. Conclusions: MT reduces MEV and therefore, whenever implemented to a large extent, may improve the quality of health care delivery and the performance of national health systems. (C) 2015 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.