At the start of 2020, the Ohio State University Wexner Medical Center’s new Center for Primary Care Innovation and Transformation launched a virtual care initiative that includes email interactions, telephone calls, video visits and e-consults. A few weeks after the COVID-19 surge, virtual care tool adoption grew from 5% to 93%. To support PCP training requests, the program convened a multi-disciplinary team including “physicians, electronic health record (EHR) and information technology (IT) professionals, process improvement and ambulatory leadership, communications experts, and patient experience advocates.” The authors, who include E-Consult Workgroup member J. Nwando Olayiwola, MD, conclude that “recommendations, best practices, lessons learned, and strategies to thrive in an ever-changing landscape will become core to the new norm in primary care.”
An evaluation of e-consult implementation conducted leadership interviews and analyzed e-consult platform metrics for 5 publicly financed, California county-based health systems that each serve 40,000 to 180,000 culturally and linguistically diverse patients across 4 to 19 primary care locations. The study concludes that successful e-consult implementation leverage prior primary care and specialty care clinician relationships and integrate EHR and e-consult platforms.
“eConsults and Learning Between Primary Care Providers and Specialists” Family Medicine, July-August 2019
An assessment of primary care providers view on e-consults’ reviewed free-text comments included in closeout surveys. In their free-text comments, PCPs “described eConsult’s ability to foster stronger relationships with specialists, deliver responses that provided teaching in multiple areas of their practice, and support further learning”, demonstrating e-consults’ educational value for providers.
“Electronic consultation impact from the primary care clinician perspective: Outcomes from a national sample” Journal of Telemedicine and Telecare, July 2018
In a retrospective analysis of provider-reported e-consult outcomes from March 2017 to January 2018, 75% of primary care clinicians reported improved care plans and 50% reported educational benefits. Conclusion: “Findings suggest that eConsults demonstrate important educational benefits, but may also influence PCC decision-making in a way that yields tremendous cost-saving potential and improved patient experience.”
“Optimizing Electronic Consultation Between Primary Care Providers and Psychiatrists: Mixed-Methods Study” Journal of Medical Internet Research, April 2018
This mixed-methods study converges quatitative data from pychiatric e-consults and qualitative data from primary care provider interviews into recommendations to expand the use of econsults between PCPs and psychiatrists. The study’s authors conclude, “E-consult is a viable and timely way for PCPs to get much-needed psychiatric advice. For optimizing its utility and uptake, e-consult needs to be integrated into reliable care pathways with adequate referrer and consultant preparation.”
“Unique Educational Opportunities for [Primary Care Providers] and Specialists Arising From Electronic Consultation Services”Academic Medicine, January 2017
“Disruptive Innovation: Implementation of Electronic Consultations in a Veterans Affairs Health Care System” Journal of Medical Internet Research, December 2016