{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T02:06:08Z","timestamp":1790906768104,"version":"4.1.0"},"reference-count":27,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2019,2,25]],"date-time":"2019-02-25T00:00:00Z","timestamp":1551052800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Telemed Telecare"],"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cardiovascular electronic consultation is a new service line in consultative medicine and enables care without in-person office visits. We aimed to evaluate accessibility and time saved as measures of efficiency, determine the safety of cardiology electronic consultations, and assess satisfaction by responding cardiologists.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using a mixed-methods approach and a modified time-driven, activity-based, costing framework, we retrospectively analysed cardiology electronic consultations. A random subset of 500 electronic consultations referred between 2013\u20132017 were reviewed. Accessibility was determined based upon increased number of patients served without the need for an in-person clinic visit. To assess safety, medical records were reviewed for emergency room visits or hospital admission at six months from the initial electronic consultation date. Responding cardiologist satisfaction was assessed by voluntary completion of an online survey.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The majority of electronic consultations were related to medication advice, clearance for surgery, evaluation of images, or guidance after abnormal testing. Recommendations included echo (10.8%), stress testing (5.0%), other imaging (4.0%) and other subspecialist referrals (3.8%). Electronic consultations were completed within 0.7\u00b10.5 days of the request, with a time to completion of 5\u201330 min. Over a six-month follow-up, 13.9% of patients had an in-person visit and 2.2% of patients were hospitalised, but none were directly related to the electronic consultation question. Satisfaction by responding cardiologists was modest.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In conclusion, within a single-payer system, cardiology electronic consultations represent a convenient and safe alternative for providing consultative cardiovascular care, but further optimization is necessary to minimise electronic consultation fatigue experienced by cardiologists.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1357633x19828130","type":"journal-article","created":{"date-parts":[[2019,2,26]],"date-time":"2019-02-26T02:22:35Z","timestamp":1551147755000},"page":"341-348","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":23,"title":["Cardiology electronic consultations: Efficient and safe, but consultant satisfaction is equivocal"],"prefix":"10.1177","volume":"26","author":[{"given":"Brenton S","family":"Bauer","sequence":"first","affiliation":[{"name":"Division of Cardiology, David Geffen School of Medicine at UCLA, USA"},{"name":"VA Greater Los Angeles Healthcare System, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ai Len","family":"Nguyen-Phan","sequence":"additional","affiliation":[{"name":"Division of Cardiology, David Geffen School of Medicine at UCLA, USA"},{"name":"VA Greater Los Angeles Healthcare System, USA"},{"name":"University of California, Los Angeles, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael K","family":"Ong","sequence":"additional","affiliation":[{"name":"VA Greater Los Angeles Healthcare System, USA"},{"name":"Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at UCLA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boback","family":"Ziaeian","sequence":"additional","affiliation":[{"name":"Division of Cardiology, David Geffen School of Medicine at UCLA, USA"},{"name":"VA Greater Los Angeles Healthcare System, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8854-2976","authenticated-orcid":false,"given":"Kim-Lien","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Division of Cardiology, David Geffen School of Medicine at UCLA, USA"},{"name":"VA Greater Los Angeles Healthcare System, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2019,2,25]]},"reference":[{"key":"bibr1-1357633X19828130","doi-asserted-by":"publisher","DOI":"10.1258\/135763303771005270"},{"key":"bibr2-1357633X19828130","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1215594"},{"key":"bibr3-1357633X19828130","doi-asserted-by":"publisher","DOI":"10.1176\/ajp.129.5.624"},{"key":"bibr4-1357633X19828130","doi-asserted-by":"publisher","DOI":"10.1002\/bsl.811"},{"key":"bibr5-1357633X19828130","first-page":"e302","volume":"16","author":"Hill RD","year":"2010","journal-title":"Am J Manag Care"},{"key":"bibr6-1357633X19828130","unstructured":"Broderick A. The Veterans Health Administration: Taking home telehealth services to scale nationally.\n                      Commonwealth Fund Pub\n                      1657: 4, https:\/\/www.commonwealthfund.org\/sites\/default\/files\/documents\/___media_files_publications_case_study_2013_jan_1657_broderick_telehealth_adoption_vha_case_study.pdf (2013, accessed 1 January 2018)."},{"key":"bibr7-1357633X19828130","unstructured":"U.S. Department of Veterans Affairs. Restoring trust in veteran's health care. Fiscal Annual Report, 2016, https:\/\/www.va.gov\/finance\/afr\/index.asp (2016, accessed 1 January 2018)."},{"key":"bibr8-1357633X19828130","unstructured":"Horner K, Wagner E, Tufano J. Electronic consultations between primary and specialty care clinicians: Early insights.\n                      The Commonwealth Fund\n                      2011; 23, https:\/\/www.commonwealthfund.org\/sites\/default\/files\/documents\/___media_files_publications_issue_brief_2011_oct_1554_horner_econsultations_primary_specialty_care_clinicians_ib.pdf (2011, accessed 1 January 2018)."},{"key":"bibr9-1357633X19828130","first-page":"e648","volume":"21","author":"Kirsh S","year":"2015","journal-title":"Am J Manag Care"},{"key":"bibr10-1357633X19828130","doi-asserted-by":"publisher","DOI":"10.2196\/medinform.4801"},{"key":"bibr11-1357633X19828130","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2014.09.061"},{"key":"bibr12-1357633X19828130","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0190247"},{"key":"bibr13-1357633X19828130","doi-asserted-by":"publisher","DOI":"10.1097\/HCM.0b013e318196def8"},{"key":"bibr14-1357633X19828130","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-009-0955-3"},{"key":"bibr15-1357633X19828130","volume-title":"Educational research: Planning, conducting, and evaluating quantitative and qualitative research","author":"Creswell J.","year":"2005"},{"key":"bibr16-1357633X19828130","volume-title":"Mixed methodology: Combining qualitative and quantitative approaches","author":"Tashakkori A","year":"1998"},{"key":"bibr17-1357633X19828130","first-page":"131","volume":"82","author":"Kaplan RS","year":"2004","journal-title":"Harv Bus Rev"},{"key":"bibr18-1357633X19828130","doi-asserted-by":"publisher","DOI":"10.1016\/j.healthpol.2017.04.013"},{"key":"bibr19-1357633X19828130","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2015.11.019"},{"key":"bibr20-1357633X19828130","doi-asserted-by":"publisher","DOI":"10.1370\/afm.1869"},{"key":"bibr21-1357633X19828130","first-page":"135","volume":"63","author":"Abouali J","year":"2017","journal-title":"Can Fam Physician"},{"key":"bibr22-1357633X19828130","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2296-15-16"},{"key":"bibr23-1357633X19828130","doi-asserted-by":"publisher","DOI":"10.2196\/medinform.3725"},{"key":"bibr24-1357633X19828130","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2015-010920"},{"key":"bibr25-1357633X19828130","doi-asserted-by":"publisher","DOI":"10.1177\/1357633X15582108"},{"key":"bibr26-1357633X19828130","doi-asserted-by":"crossref","unstructured":"Sayre GG, et al. Adopting SCAN-ECHO: The providers' experiences.\n                      Healthc (Amst)\n                      2017; 5(1\u20132): 29\u201333.","DOI":"10.1016\/j.hjdsi.2016.04.006"},{"key":"bibr27-1357633X19828130","unstructured":"American Dental Association. Oral health topics: Antibiotic prophylaxis prior to dental procedures, https:\/\/www.ada.org\/en\/member-center\/oral-health-topics\/antibiotic-prophylaxis (accessed 1 January 2018)."}],"container-title":["Journal of Telemedicine and Telecare"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1357633X19828130","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1357633X19828130","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1357633X19828130","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T03:12:54Z","timestamp":1777691574000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1357633X19828130"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,2,25]]},"references-count":27,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2020,7]]}},"alternative-id":["10.1177\/1357633X19828130"],"URL":"https:\/\/doi.org\/10.1177\/1357633x19828130","relation":{},"ISSN":["1357-633X","1758-1109"],"issn-type":[{"value":"1357-633X","type":"print"},{"value":"1758-1109","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,2,25]]}}}