E-Consult Satisfaction
“Comparing Patients’ Experiences with Electronic and Traditional Consultation: Results from a Multisite Survey” Journal of General Internal Medicine, February 2020
A series of patient surveys conducted by AAMC Project Core deliver valuable insights into patient awareness of e-consults by comparing patient experience with e-consults to patient experience with in-person referrals. Among the 8087 patients that completed surveys, 11.6% had e-consults and 88.4% had in-person referrals. Both groups reported similar levels of satisfaction and specialist recommendation understanding as well as similar acceptance of e-consults and in-person referrals. This comparative research counters provider concerns that patients would perceive e-consults as a low quality care, adding another layer to the high value of e-consults.
“Patients Assess an eConsult Model’s Acceptability at 5 US Academic Medical Centers” Annals of Family Medicine, January/February 2020
To assess patient perspectives on e-consults, researchers conducted primary patient focus groups at five AAMC Project CORE academic medical centers to explore patient opinions about e-consults. “All focus groups felt that econsult would result in better care, time and cost savings, and shorter wait times for appointments with specialists,” the authors note. Patients maintained a positive perspective as long as e-consults did not replace needed in-person appointments and that patients would not have a copay for their use. The focus group input revealed that “patient involvement in outreach and education efforts could help to improve econsult models and enhance their uptake.”
“E-consults in gastroenterology: An opportunity for innovative care synthesis” Journal of Telemedicine and Telecare, July 2018
A survey by Massachusetts General Hospital researchers found that 84% of referring providers strongly agreed that gastroenterology e-consults promoted good patient care and 84% were satisfied with the program. Conclusion: “E-consults in gastroenterology have the potential to reduce unnecessary visits and/or procedures for patients who can be managed by their primary provider, potentially increasing access for other patients.”
“Primary Care Practitioners’ Perceptions of Electronic Consult Systems: A Qualitative Analysis” JAMA Internal Medicine, June 2018
To assess primary care providers’ perceptions of econsult workflow, specialist access and patient care7 researchers interviewed 40 safety-net primary care providers in Los Angeles County who use the Los Angeles County Department of Health Services (DHS) eConsult system. The PCPs consistently perceived that e-consults shifted some specialty care to them and many also believed that providing patients with access to timely specialty care management was worth the extra work burden. In contrast, others were frustrated by the increased administrative burden, broadened clinical responsibility, and restructuring of specialty care delivery. The study authors conclude, “For health systems planning to implement eConsult, the LA County DHS eConsult experience can offer important lessons in anticipating challenges with PCP expectations, workflow changes, and new problems emerging with health information technology adoption.”
“eConsult—Transforming Primary Care or Exacerbating Clinician Burnout?” JAMA Internal Medicine, June 2018
A commentary on the qualitative analysis of primary care providers’ econsult perceptions by three E-Consult Workgroup members provides guidence on how to implement econsults without adding provider frustration and professional burnout. This guidance includes the following:
- Identify and eliminate low-value tasks to free PCP time for new, higher-value activities
- Ensure that e-consult’s technology user interface doesn’t increase frustration
- Provide dedicated time for non-face-to-face care activities and to carry out activities recommended by specialists through e-consult
“Understanding the Potential for Patient Engagement in Electronic Consultation and Referral Systems: Lessons From One Safety Net System.” Health Services Research, September 2017
“Veteran, primary care provider, and specialist satisfaction with electronic consultation.” JMIR Medical Informatics, January 2015
“Comparing virtual consults to traditional consults using an electronic health record: an observational case–control study” BMC Medical Informatics, July 2012