The American journal of managed care
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Electronic consultations, or e-consults, between primary care providers and specialists have been shown to improve access to specialty care, shorten wait times, and reduce outpatient visits. The objective of this study was to evaluate differences in health care costs between patients who received an electronic specialty consultation and patients who received a face-to-face specialty consultation. ⋯ Electronic specialty consultations are a potential mechanism to reduce health care costs and promote the efficient use of health care resources.
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With a rapid shift to telehealth during the coronavirus disease 2019 (COVID-19) pandemic, clinicians, health care organizations, and policy makers must consider and address patients' evolving needs, concerns, and expectations.
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To determine whether physician-to-physician outpatient asynchronous store-and-forward teledermatology can be a portal for patient access to consultative dermatologic care and decrease primary care physician referrals to dermatology. ⋯ Physician-to-physician outpatient asynchronous teledermatology consults can provide a model for rapid consultation and decreased primary care referral to dermatology.
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A letter from the guest editor highlights the contributions of health information technology in improving health care delivery patient-centeredness through innovation in data analytics, connecting providers, and implementation of telehealth.
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Chronic infection with hepatitis C virus (HCV) is common, but underdiagnosed and undertreated worldwide. The most important treatment outcome in HCV is sustained virological response (SVR), due to its impact on reducing the risks of liver-related mortality, hepatocellular carcinoma, and hepatic decompensation. The degree of baseline liver disease, IL28B genotype, and HCV genotype are important determinants of response to treatment, and SVR rates less than 50% can be expected for persons with genotype 1 receiving standard peginterferon with ribavirin. ⋯ There is little evidence supporting improved outcomes with peginterferon and ribavirin retreatment, and escalation of ribavirin dosage leads to an increased risk of adverse events. Introduction of the protease inhibitors, boceprevir and telaprevir, has resulted in SVR rates between 67% and 79% when used as part of a triple therapy regimen, which has become the standard of care for those with genotype 1 HCV. More work is needed to develop strategies to further improve treatment outcomes, and ideally to develop a vaccine to prevent the development of chronic HCV.