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A Data Model for Teleconsultation in Managing High-Risk Pregnancies: Design and Preliminary Evaluation.

A Data Model for Teleconsultation in Managing High-Risk Pregnancies: Design and Preliminary Evaluation.
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Deldar K, Tara F, Bahaadinbeigy K, Khajedaluee M, Tara M,


Deldar K, Tara F, Bahaadinbeigy K, Khajedaluee M, Tara M, (click to view)

Deldar K, Tara F, Bahaadinbeigy K, Khajedaluee M, Tara M,

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JMIR medical informatics 2017 12 145(4) e52 doi 10.2196/medinform.8393
Abstract
BACKGROUND
Teleconsultation is a guarantor for virtual supervision of clinical professors on clinical decisions made by medical residents in teaching hospitals. Type, format, volume, and quality of exchanged information have a great influence on the quality of remote clinical decisions or tele-decisions. Thus, it is necessary to develop a reliable and standard model for these clinical relationships.

OBJECTIVE
The goal of this study was to design and evaluate a data model for teleconsultation in the management of high-risk pregnancies.

METHODS
This study was implemented in three phases. In the first phase, a systematic review, a qualitative study, and a Delphi approach were done in selected teaching hospitals. Systematic extraction and localization of diagnostic items to develop the tele-decision clinical archetypes were performed as the second phase. Finally, the developed model was evaluated using predefined consultation scenarios.

RESULTS
Our review study has shown that present medical consultations have no specific structure or template for patient information exchange. Furthermore, there are many challenges in the remote medical decision-making process, and some of them are related to the lack of the mentioned structure. The evaluation phase of our research has shown that data quality (P<.001), adequacy (P<.001), organization (P<.001), confidence (P<.001), and convenience (P<.001) had more scores in archetype-based consultation scenarios compared with routine-based ones. CONCLUSIONS
Our archetype-based model could acquire better and higher scores in the data quality, adequacy, organization, confidence, and convenience dimensions than ones with routine scenarios. It is probable that the suggested archetype-based teleconsultation model may improve the quality of physician-physician remote medical consultations.

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