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dc.contributor.authorFernández-Méndez, Rocíoen
dc.contributor.authorWong, Mei Yinen
dc.contributor.authorRastall, Rebecca Jen
dc.contributor.authorRebollo-Díaz, Samuelen
dc.contributor.authorOberg, Ingelaen
dc.contributor.authorPrice, Stephenen
dc.contributor.authorJoannides, Alexisen
dc.date.accessioned2019-12-20T00:30:51Z
dc.date.available2019-12-20T00:30:51Z
dc.date.issued2020-03-05en
dc.identifier.issn1438-8871
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/300167
dc.description.abstractBACKGROUND: Quality referrals to specialist care are key for prompt, optimal decisions about the management of patients with brain tumours. Objective: We aimed to determine the impact of introducing an web-based, electronic referral (eReferral) system to a specialised neuro-oncology centre, using a service-developed proforma, in terms of waiting times and information completeness. METHODS: We carried out a retrospective cohort study based on the review of medical records of referred adult patients, excluding follow-ups. Primary outcome measures were durations of 3 key phases within the referral pathway and completion rates of 6 referral fields. RESULTS: 248 patients were referred to the specialist centre during the study period. Median (IQR) diagnostic-imaging-to-referral intervals were 3 (1,5) days with eReferrals, and 9 (4,19), 19 (14,49) and 8 (4,23) days with paper-proforma, paper-letter and internal referrals respectively (P<0.001). Median (IQR) referral-to-MDT-decision intervals were 3 (2,7), 2 (1,3), 8 (2,24) and 3 (2,6) days respectively (P=0.011). For patients having surgery, median (IQR) diagnostic-imaging-to-surgery were 28 (21,41), 34 (27,51), 104 (69,143) and 32 (15,89) days, respectively (P<0.001). Proportions of complete fields differed significantly by referral type in all study fields (all with P<0.001) except for details of presentation, which were present in all referrals. All study fields were always present in eReferrals, as these are compulsory for referral submission. Depending on the data field, level of completeness in the remaining referral types ranged within 69-87%, 15%-65% and 22-63% in paper-proforma, paper-letter and internal referrals respectively. CONCLUSIONS: An electronic, web-based, service-developed specific proforma for neuro-oncology referrals performs significantly better, with shorter waiting times and greater completeness of information, than other referral types. A wider application of eReferrals is an important first step to streamlining specialist care pathways and providing excellent care.
dc.description.sponsorshipInnovate UK NIHR Brain Injury MedTech Cooperative
dc.format.mediumElectronicen
dc.languageengen
dc.rightsAll rights reserved
dc.rights.uri
dc.titleImprovement of the Efficiency and Completeness of Neuro-Oncology Patient Referrals to a Tertiary Center Through the Implementation of an Electronic Referral System: Retrospective Cohort Study.en
dc.typeArticle
prism.issueIdentifier3en
prism.publicationDate2020en
prism.publicationNameJournal of medical Internet researchen
prism.startingPagee15002
prism.volume22en
dc.identifier.doi10.17863/CAM.47238
dcterms.dateAccepted2019-12-16en
rioxxterms.versionofrecord10.2196/15002en
rioxxterms.versionAM
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserveden
rioxxterms.licenseref.startdate2020-03-05en
dc.contributor.orcidFernández-Méndez, Rocío [0000-0002-4989-0687]
dc.contributor.orcidWong, Mei Yin [0000-0003-0856-1446]
dc.contributor.orcidRastall, Rebecca J [0000-0003-4034-8274]
dc.contributor.orcidRebollo-Díaz, Samuel [0000-0002-3469-4050]
dc.contributor.orcidOberg, Ingela [0000-0003-4218-0575]
dc.contributor.orcidPrice, Stephen John [0000-0002-7535-3009]
dc.contributor.orcidJoannides, Alexis [0000-0002-6618-256X]
dc.identifier.eissn1438-8871
rioxxterms.typeJournal Article/Reviewen
pubs.funder-project-idTechnology Strategy Board (102111)
cam.orpheus.counter2*
rioxxterms.freetoread.startdate2022-12-19


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