Teleconsultation Services in Pediatric Primary Care in Austria: Upgrading Clinical Decision Support in Primary Health Care Settings.

ABSTRACT

Introduction: The general practitioners' increasing comprehensive pediatric health care provision in Austria faces great challenges in ensuring high-quality health care in the future as the shortage of pediatricians continues to grow. Tele-expertise services provide an excellent opportunity to facilitate and strengthen interdisciplinary collaboration and access medical expertise of uncertainties in diagnosis and treatment plans. The purpose of this study was to investigate and evaluate the usability, applicability, and clinical advantages of an Austrian tele-expertise platform for doctors, emphasizing its value to strengthen collaborative efforts to extend and ensure quality care in infant, child, and adolescent health while focusing on diagnostic acceleration, verification, and potential modification of a treatment plan. Materials and Methods: A mixed-method approach included the retrospective evaluation of data provided via Intercom to elicit professional and geographical distribution and analysis of four hypotheses (H1 geographic distribution of initial enquires; H2 pediatric expertise level of the requester; H3 teleconsultations will result in changes in diagnosis and therapeutic decisions; and H4 teleconsultations stimulate cooperation and collaboration between physicians of all specialties). The study was based on survey questionnaires and qualitative semi-structured interviews. Discussion: Benefits were the most apparent in shorter diagnosis times, a potential quality increase in care, and cooperative stimulation. Intended therapy plans were found to be more sensitive to modification. Nevertheless, an overall positive attitude toward the teleconsultation chat became obvious. Moreover, the potential regarding quality improvements in pediatric primary care, shorter diagnosis time, and improved treatment options was found. Conclusions: Outcomes are urging Austrian health authorities to establish political and legal structures for appropriate monetary compensation and broad application of an expert consultation system. The article further highlights the importance of teleconsultations in critical situations, such as pandemic times.