Models of communication between medical specialists and general practitioners

Alberte Rodskjer

Background:

Communication between medical specialists in the hospitals and general practitioners are crucial to ensure coherency of patient pathways and patient safety. Nevertheless, insufficient intersectoral communication remains a challenge, and has been addressed at different levels numerous times.

Research questions:

To map models for improved intersectoral communication and to explore how these models work, we ask this question:
What models of communication between hospital specialists and general practitioners can be identified in Danish and international literature, and what experiences have been reported?

Method:

Since the concept of communication models is broad by nature, we conduct a scoping review to comprise potentially diverse models within the field of intersectoral communication in the healthcare sector. The scoping review is conducted accordingly to the PRISMA-Scr guidelines. The literature search has been conducted in two different databases, and the references have been screened and assessed accordingly to the agreed eligibility criteria.

Results:

The scoping review shows that most of the models identified aim to improve communication by facilitating interprofessional consultation. Specifically, e-consultation that allows primary care providers to consult specialists for advice occur frequently in the literature. Overall, the studies report positive evaluations, and several studies report reductions in the number of referrals planned before and after e-consultation.
We rarely find models that aim to improve communication initiated by the hospital specialists or models that specifically seek to enhance inter-professional relations. Furthermore, only a few studies investigate economic or health effects of communication models.

Conclusions:

Despite a broad concept of interest, the scoping review reveals a relatively homogeneous body of communication models. E-consultation is the most frequently tested model, and overall it seems to be able to support primary care providers in managing patients.

Please note that results and conclusion are with reservations to further examination.

Points for discussion:

How to distinguish telehealth/telemedicine from electronic communication between healthcare professionals – and is a distinction fruitful at all?

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