TY  - JOUR
AU  - Accorsi, Tarso Augusto Duenhas
AU  - Eduardo, Anderson Aires
AU  - Baptista, Carlos Guilherme
AU  - Moreira, Flavio Tocci
AU  - Morbeck, Renata Albaladejo
AU  - Köhler, Karen Francine
AU  - Lima, Karine de Amicis
AU  - Pedrotti, Carlos Henrique Sartorato
PY  - 2024
DA  - 2024/10/25
TI  - The Impact of International Classification of Disease–Triggered Prescription Support on Telemedicine: Observational Analysis of Efficiency and Guideline Adherence
JO  - JMIR Med Inform
SP  - e56681
VL  - 12
KW  - telemedicine
KW  - clinical decision support systems
KW  - electronic prescriptions
KW  - guideline adherence
KW  - consultation efficiency
KW  - International Classification of Disease–coded prescriptions
KW  - teleheath
KW  - eHealth
AB  - Background: Integrating decision support systems into telemedicine may optimize consultation efficiency and adherence to clinical guidelines; however, the extent of such effects remains underexplored. Objective: This study aims to evaluate the use of ICD (International Classification of Disease)-coded prescription decision support systems (PDSSs) and the effects of these systems on consultation duration and guideline adherence during telemedicine encounters. Methods: In this retrospective, single-center, observational study conducted from October 2021 to March 2022, adult patients who sought urgent digital care via direct-to-consumer video consultations were included. Physicians had access to current guidelines and could use an ICD-triggered PDSS (which was introduced in January 2022 after a preliminary test in the preceding month) for 26 guideline-based conditions. This study analyzed the impact of implementing automated prescription systems and compared these systems to manual prescription processes in terms of consultation duration and guideline adherence. Results: This study included 10,485 telemedicine encounters involving 9644 patients, with 12,346 prescriptions issued by 290 physicians. Automated prescriptions were used in 5022 (40.67%) of the consultations following system integration. Before introducing decision support, 4497 (36.42%) prescriptions were issued, which increased to 7849 (63.57%) postimplementation. The physician’s average consultation time decreased significantly to 9.5 (SD 5.5) minutes from 11.2 (SD 5.9) minutes after PDSS implementation (P<.001). Of the 12,346 prescriptions, 8683 (70.34%) were aligned with disease-specific international guidelines tailored for telemedicine encounters. Primary medication adherence in accordance with existing guidelines was significantly greater in the decision support group than in the manual group (n=4697, 93.53% vs n=1389, 49.14%; P<.001). Conclusions: Most of the physicians adopted the PDSS, and the results demonstrated the use of the ICD-code system in reducing consultation times and increasing guideline adherence. These systems appear to be valuable for enhancing the efficiency and quality of telemedicine consultations by supporting evidence-based clinical decision-making. 
SN  - 2291-9694
UR  - https://medinform.jmir.org/2024/1/e56681
UR  - https://doi.org/10.2196/56681
UR  - http://www.ncbi.nlm.nih.gov/pubmed/39453703
DO  - 10.2196/56681
ID  - info:doi/10.2196/56681
ER  -