“Pediatric dermatology eConsults: Reduced wait times and dermatology office visits” Pediatric Dermatology, June 2020
Harvard Medical School researchers conducted a retrospective cohort study of dermatology e-consults for patients under 18 years old completed between November 2014 and December 2018. Of the 188 e-consults, 53.7% were resolved without a face-to-face visit generating potential savings of $24,059. Authors conclude that the e-consults reduce needs for face-to-face visits and “offer potential costs savings for payers and patients”
Massachusetts General Hospital researchers’ analysis of e-consult use from February 1 through April 1st for ambulatory care revealed an increase during the COVID-19 pandemic. The study’s interrupted time series model applied the “intervention date” of March 11th, when Massachusetts declared its pandemic-related state of emergency. Results showed a proportional increase of econsult volumes over ambulatory care volumes of 5% before March 11th to 19% after March 11th. The study’s authors conclude that econsults are a “promising method of ambulatory consultative care delivery [that] can potentially replace some specialty consultations in a manner that provides clinical guidance while reducing the risk of in-person visits to both patients and physicians.”
The first study of e-consult use among long-term care (LTC) facility providers analyzed its use in LTC homes across Eastern Ontario, Canada during 2018. Among the 64 e-consult submissions to 23 specialties, 70% were resolved without face-to-face visits, a signifcant benefit for seniors that face extreme challenges for in-person appointment travel.
“Impact of Endocrinology eConsults on Access to Endocrinology Care for Medicaid Patients” Telemedicine and e-Health, February 2020
For medically underserved populations, endocrinology access is difficult. This retrospective cohort study finds that e-consults signifinantly improve care for Medicaid patients by decreasing the need for face-to-face visits and enabling PCPs to address specialty-related issues in primary care.
A review of allergy and immunology e-consults from April to October 2019 which analyzed indication, recommendations, and completion/turnaround times found that 64% provided diagnostic and/or management guidance and 15% recommended subsequent in-person A/I consult. The study concludes that inpatient e-consults efficiently and rapidly deliver formally-documented allergist guidance for hospitalized patients, maintaining quality of care while minimally disrupting ambulatory allergy practice.
“Improved patient access and outcomes with the integration of an eConsult program (teledermatology) within a large academic medical center” Journal of American Academy of Dermatology, October 2019
To determine e-consults’ ability to alleviate insurance, racial, and socioeconomic health disparities, Ohio State University Wexner Medical Center Researchers conducted a cross-sectional evaluation of all ambulatory dermatology referrals and electronic dermatology consultations over a 25-month period. Results showed that e-consults served more non-white patients and Medicaid enrollees, and authors conclude that “telemedicine system can result in improved access for underserved patients.”
“Improving Equity of Access Through Electronic Consultation: A Case Study of an eConsult Service” Public Health, October 2019
This Canadian study demonstrates that e-consults provide specialty care access to patients facing care inequities which include “age, socioeconomic status, cultural or racial background, sexual orientation, and functional health.” The study finds that the links between primary care providers and specialists improve care quality because they avoid long wait times that inequitities impose.
“Electronic consultations (e-consults) to improve access to specialty care: a systematic review and narrative synthesis” Journal of Telemedicine and Telecare, Sept 2015
“Los Angeles Safety-Net Program eConsult System Was Rapidly Adopted And Decreased Wait Times To See Specialists” Health Affairs, March 2017