gms | German Medical Science

In recent years, telephone consultation and triage have increasingly been used as a means for healthcare delivery. This procedure has been described as “the process where calls from people with a healthcare problem are received, assessed and managed by giving advice or by referral to a more appropriate service”. One main motive for introducing such services was to help callers to self-manage their health problems and to reduce unnecessary demands on other healthcare services. Quality assurance is crucial for safety and effectiveness of teleconsultations. The Swiss Centre for Telemedicine Medgate is one of the largest teleconsultation centres in Europe. More than half of the insured persons in Switzerland have access to our services. This presentation will describe how we use clinical protocols as a means for quality assurance in our centre. According to our definition, a clinical protocol is a guidance derived from clinical practice guidelines containing concrete criteria for individual medical decisions. We will comment on the available evidence specific to the telemedicine setting and will describe how we adopt other existing guidelines to our setting. One major issue is to find a balance between safety concerns and efficiency (as measured by the rate of patients not in need for further face-to-face consultations). In summary, this talk will present a case study of evidence-based protocol development and implementation in a setting other than usual face-to-face medicine.