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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.


Change in the process (degradation) from baseline.
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Figure 3: Change in the process (degradation) from baseline.

Mentions: Once the baseline transfer function has been established, it can be used to detect changes in the behavior of the network. For example, the transfer function analysis could be repeated after about 6 months, and compared with the baseline (Figure 3).


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)

Change in the process (degradation) from baseline.
© Copyright Policy
Related In: Results  -  Collection

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

Figure 3: Change in the process (degradation) from baseline.
Mentions: Once the baseline transfer function has been established, it can be used to detect changes in the behavior of the network. For example, the transfer function analysis could be repeated after about 6 months, and compared with the baseline (Figure 3).

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.