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Relationship between the Quality of Service Provided through Store-and-Forward Telemedicine Consultations and the Difficulty of the Cases - Implications for Long-Term Quality Assurance.

Wootton R, Liu J, Bonnardot L - Front Public Health (2015)

Bottom Line: Based on the consensus scores, there was a weak negative relation between output quality and case difficulty, i.e., the more difficult cases tended to result in lower quality consultations.However, the effect was non-significant (P = 0.59) and a larger study might be helpful.As yet, there is no evidence on which to base a correction for case difficulty.

View Article: PubMed Central - PubMed

Affiliation: Norwegian Centre for Integrated Care and Telemedicine, University Hospital of North Norway , Tromsø , Norway ; Faculty of Health Sciences, University of Tromsø , Tromsø , Norway.

ABSTRACT
We examined the difficulty of telemedicine cases and the quality of the resultant consultation in a mature store-and-forward telemedicine network. A random sample of 10 telemedicine cases was selected from those occurring over a 3-month period (5% of the workload) and they were scored by three experienced observers. Inter-observer agreement on the difficulty scores was poor (Fleiss's kappa = 0.18) and it was also poor on the consultation quality scores (Fleiss's kappa = 0.11). Differences between observers were minimized by consensus scoring, and the cases were re-assessed jointly by two observers. Based on the consensus scores, there was a weak negative relation between output quality and case difficulty, i.e., the more difficult cases tended to result in lower quality consultations. However, the effect was non-significant (P = 0.59) and a larger study might be helpful. In the meantime, routine monitoring of telemedicine service quality will continue in the interests of quality assurance. As yet, there is no evidence on which to base a correction for case difficulty.

No MeSH data available.


Relation between the difficulty of the case and the quality of the response produced by the network.
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Figure 2: Relation between the difficulty of the case and the quality of the response produced by the network.

Mentions: If the input and output of a telemedicine network (i.e., case difficulty and consultation quality) can be measured, then the process itself can be quantified; this is analogous to the transfer function describing the behavior of a black box model. Measuring the transfer function can be done using a sample of cases that cover a range of input values (Figure 2). The best descriptor of the process can be established from the observations which have been made by regression analysis. Note, however, that each variable has an observational error (since each will be estimates from a panel of observers). So techniques for regression with errors in both Y and X are required, i.e., this is not the standard regression situation.


Relationship between the Quality of Service Provided through Store-and-Forward Telemedicine Consultations and the Difficulty of the Cases - Implications for Long-Term Quality Assurance.

Wootton R, Liu J, Bonnardot L - Front Public Health (2015)

Relation between the difficulty of the case and the quality of the response produced by the network.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4585167&req=5

Figure 2: Relation between the difficulty of the case and the quality of the response produced by the network.
Mentions: If the input and output of a telemedicine network (i.e., case difficulty and consultation quality) can be measured, then the process itself can be quantified; this is analogous to the transfer function describing the behavior of a black box model. Measuring the transfer function can be done using a sample of cases that cover a range of input values (Figure 2). The best descriptor of the process can be established from the observations which have been made by regression analysis. Note, however, that each variable has an observational error (since each will be estimates from a panel of observers). So techniques for regression with errors in both Y and X are required, i.e., this is not the standard regression situation.

Bottom Line: Based on the consensus scores, there was a weak negative relation between output quality and case difficulty, i.e., the more difficult cases tended to result in lower quality consultations.However, the effect was non-significant (P = 0.59) and a larger study might be helpful.As yet, there is no evidence on which to base a correction for case difficulty.

View Article: PubMed Central - PubMed

Affiliation: Norwegian Centre for Integrated Care and Telemedicine, University Hospital of North Norway , Tromsø , Norway ; Faculty of Health Sciences, University of Tromsø , Tromsø , Norway.

ABSTRACT
We examined the difficulty of telemedicine cases and the quality of the resultant consultation in a mature store-and-forward telemedicine network. A random sample of 10 telemedicine cases was selected from those occurring over a 3-month period (5% of the workload) and they were scored by three experienced observers. Inter-observer agreement on the difficulty scores was poor (Fleiss's kappa = 0.18) and it was also poor on the consultation quality scores (Fleiss's kappa = 0.11). Differences between observers were minimized by consensus scoring, and the cases were re-assessed jointly by two observers. Based on the consensus scores, there was a weak negative relation between output quality and case difficulty, i.e., the more difficult cases tended to result in lower quality consultations. However, the effect was non-significant (P = 0.59) and a larger study might be helpful. In the meantime, routine monitoring of telemedicine service quality will continue in the interests of quality assurance. As yet, there is no evidence on which to base a correction for case difficulty.

No MeSH data available.