Is natural patient preconsultation data medically relevant for outpatient and primary care in cardiology?

Abstract

Abstract Digital cardiology may improve the organization and efficiency of outpatient care. The patient direct contribution to medical data is an important cornerstone to save medical time, shorten the decision-making process and improve prevention. However, the medical impact of potential errors in this natural data is unclear. Purpose We aimed to evaluate and quantitate the errors and differences between data completed by patient and trained medical teams using a preconsultation medical form in cardiology. Methods 476 consecutive patients scheduled for an outpatient cardiology consultation (January 2020) were included in the study in one medical center (among a database of more than 13000 patients). All patients had access to a secure digital platform and were encouraged to fill a preconsultation form (risk factors, symptoms and prior medical results). This data was completed and corrected, if necessary, during the medical consultation by a trained outpatient care team and compared to the information provided by patients. An error was defined as either a missing or a wrong value, and a percentage was calculated for each parameter. Results 387 patients (83%) were included in the analysis (72 did not fill the preconsultation form, 8 did not show up for the appointment). The filling rate averaged 83.6±12%. The global error % averaged 16.5±5% (13.4% missing values). The following parameters had an error % of more than 10%: results of prior cardiac tests (echocardiography 43%, exercise test 25%, arterial Doppler 24%), history of renal failure (32%), Blood pressure value (23%), cholesterol level (20%), family cardiac history (15%), personal cardiac history (12%), history of diabetes (11%). All other parameters had an error % of less than 5% (symptoms, smoking, alcohol consumption, BMI). Despite these significant missing or erroneous data, the availability of this information allowed significant improvement of the care path and more than 80% of patients reported improved commitment and understanding of medical decisions. Conclusion Actively including patient in the medical care process is an important issue and is made easy using e-cardiology tools. The results of this study should be considered when building digital medical platforms. Some of the parameters with important errors should be verified from multiple sources before using them in the future decision-making algorithms. Funding Acknowledgement Type of funding sources: Private company. Main funding source(s): izyCardio digital e-cardiology companyCardioParc medical centers