Research Article

Referral Activity in Three Store-and-Forward Networks during the COVID-19 Coronavirus Pandemic

Table 1

Principal indicators used in the present paper.

AreaIndicatorComment

Network characteristicsType of organization
Main purpose
Types of case
Countries of operation

Network demandNumber of potential referrers
Referrers who had submitted a case
Number of potential referring sites
Referring sites from which a case had been submitted
Referrals submitted

Case mixThree most common query typesThe type of a query is defined by the specialty and subspecialty of the specialist to whom it is sent
Mean patient age in years (SD)
Sex (% male, % female)

Case complexityNumber of messages per caseThe total number of messages for the case
Number of queries per caseThe total number of queries sent to specialists
Proportion of unanswered queries (%)The proportion of the queries sent which were not answered
Dialogue time (h)The dialogue time is the interval (h) from case receipt until the last message from the referrer or specialist (excluding any progress report)

Case managementProportion of cases allocated manuallyThe proportion of cases that were not allocated automatically (i.e., by the computer) to specialists
Allocation delay (h)The allocation delay is a measure of the performance of the coordinator(s) during the period in question. Every case will result in at least one query. The interval between the arrival of the case and the first time it is allocated for reply represents the allocation delay. This is true even if say a case results in two queries, and the first goes unanswered. The allocation delay, which is measured in hours, is defined as the delay before the first query was sent out, irrespective of whether that query was actually answered. If automatic allocation is in use, then cases on which it is used will have zero allocation delay.
Number of coordinator messages per caseThe number of messages sent by the coordinator(s)

Network performanceAnswer delay (h)The answer delay is a general measure of network performance, as perceived by the referrer. The answer delay, which is measured in hours, is defined as the delay after a case has been submitted before the first reply is received from a specialist. If queries are sent to several specialists (e.g., if the case is allocated to an expert group), then, the answer delay is measured from case submission to the earliest reply received.
Number of completed questionnaires
Proportion of questionnaires completed (%)
Q6 “did you find the advice helpful?” (% yes)
Q8 “do you think the eventual outcome for the patient will be beneficial?” (% yes)
Q9 “was there any educational benefit to you in the reply?” (% yes)

Network resourcesSpecialists available
Specialists who were sent a query during 2020 (% of those available)
Specialists who answered a query during 2020 (% of those sent a query)
Case coordinators available
Case coordinators who allocated a query during 2020 (% of those available)

Network efficiencyCases per potentially-available case coordinator
Cases per actual case coordinator
Cases per potential specialist
Cases per actual specialist