February 2019


Duke Health Creates Simulation Tool that Predicts E-Consult Impact on Wait Times

The theme of the 2018 Winter Simulation Conference, which took place in Gothenburg, Sweden in December, was “Simulation for a Noble Cause!” Researchers at Duke Health submitted and then presented their “noble cause” in the form of a simulation tool using data from e-consult use at Duke Health’s Rheumatology clinics. Based on the hypothesis that e-consult decreased lead times and makes specialty clinics more efficient and effective, researchers created a simulation to estimate how e-consults will impact lead time, queue length, and specialists’ workload. The tool is adaptable and includes visualizations that any specialty clinic can use to “estimate the impact e-consults have on delivering quality care to referred patients,” write the authors.


Médecins Sans Frontières Brings E-Consult to Global Frontlines

In 2010 ,Médecins Sans Frontières began using e-consult to provide field medical staff with access to specialist advice. A study of MSF’s e-consult use over seven years demonstrates that “offering direct specialist expertise in low-resource settings improved the management of patients and provided additional educational value to the field physicians.” MSF’s specialist network comprises doctors that are part of the organization (75%) as well as volunteers located in Europe and America. Use of e-consults in MSF’s low-resource and humanitarian aid settings rose significantly among the organization’s 271 operational sites.

As the number of e-consults rose, response times decreased indicating an overall quality and performance increase.


Using Consensus Methods to Identify Features of High-Quality Specialist E-Consults 

While communication quality among providers impacts patient safety, specialists “rarely receive feedback” for written communications, according to a recent study. To evaluate what features PCPs want from specialist e-consults, researchers had PCPs and specialists collaborate to define a list. Eight PCPs and three specialists, including a dermatologist, hematologist, and pediatric orthopedist, initially created a list of 49 items that was then refined to 14 items. The results revealed that “highly-ranked items encompassed specific, up-to-date, patient-individualized, and practical advice that the PCP could implement.”


Cost Effectiveness

Cost Savings Research on E-Consult Generates Press Interest

First published in December 2018, recent research on cost savings achieved by Connecticut Community Health Center Inc’s use of e-consult has generated positive press in both  a local publications and a national medical news source. This press included the following articles:

How these 4 specialties used telemedicine to save nearly $600,000 This American Medical Association news brief focuses on e-consult’s financial benefits and AMA’s advocacy for provider reimbursement for e-consults.

Health center for the poor begets a telemedicine pioneer The Connecticut Post reports on how CHC has spun off a nonprofit technology with the goal of “radically” changing patient access to specialists. The reporter highlights e-consult’s cost savings and quality, noting CHC, Inc.’s uniqueness as a safety net health center pioneer in high-tech business.


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