Prospective study of telephone calls to a hotline for infectious disease consultation: analysis of 7,863 solicited consultations over a 1-year period

Abstract

PurposeTo respond to the increasing requests of noninfectious disease physicians for access to infectious diseases expertise, a hotline was created in the infectious diseases consultation (IDC) unit of the Grenoble university-affiliated hospital (GUH). This study describes the patterns of solicited consultations provided by the hotline during a 1-year period. MethodsWe conducted a prospective study of consecutive solicited IDCs requested by physicians in 2008. ResultsA total of 7,863 consultations were requested by physicians over 1 year; 4,407 (56.0%) by ambulatory physicians, 2,933 (37.3%) by GUH physicians, and 523 (6.7%) by physicians in public or private hospitals. The majority of consultations were requested via cell phone (58.7%). The main reasons for requesting a consultation were related to antimicrobial treatment for hospital-based physicians and prophylaxis for ambulatory physicians (p<0.001).Recommendations to perform diagnostic or monitoring tests were less frequent in ambulatory medicine (16%) than in the GUH (59%) or other hospitals (63%, p<0.001). The route of consultation for patients with nosocomial infections was more likely to be formal (p<0.001). ConclusionsThe activity of the IDC hotline attests to an important need for such expertise consultation, both in hospitals and ambulatory medicine.

Requesting physicians' experiences regarding infectious disease consultations

“…They were physicians working in medical, surgical, and intensive care units, although those working in medical and surgical units declared requesting more consultations than the others. This is concordant with a previous study conducted in the same setting showing that 55% of the 2933 consultations requested of ID specialists over 1 year came from medicine or rehabilitation units, 41% from surgical units and 2% from intensive care units [12]. We could have expected a majority of requests from surgeons as they are less experienced with IDs.…”

The advantages of using photographs and video images in telephone consultations with a specialist in paediatric surgery

“…[1] Consultation can be done at the patient's own bedding, and sometimes the general practitioner can provide information or advice by telephone. [2] The health expenditure for examination of a patient by family physician increases four times if a consultation takes places and four times if a referral takes places. [3] The most important reasons for referral are failure to diagnose the patient, the wish to seek the opinion of another, or an unconvinced parent of the patient.…”

“…Consultation can be at the patient's own request, and sometimes information or advice can be provided by telephone. [1,2] Another issue is to decide whether it is necessary to refer the patient to a specialist as a matter of urgency. It is possible to provide a definitive diagnosis of certain diseases in pediatric surgery by inspection.…”

The impact of infectious diseases consultation on oncology practice

“…Formal consultation was more commonly requested for nosocomial infection compared with communityacquired infection (44 vs. 12%, P < 0.001) [31]. Recommendations were made to modify antimicrobial therapy in up to 36% of cases, particularly in hospital settings [31]. The study was designed to demonstrate the utility and volume of consultation to a 'hotline' for consultation, not to correlate the mechanism of consultation with outcomes.…”

“…In a large hospital in France, a hotline was established for infectious diseases consultation, with formal consultation available on request [31]. Formal consultation was more commonly requested for nosocomial infection compared with communityacquired infection (44 vs. 12%, P < 0.001) [31].…”