E-Consult Efficiency

“eConsult Data Shed Light on Care Coordination Decisions During the COVID-19 Pandemic” MDedge, July/August 2020

An analysis of Inland Empire Health Plan’s (IEHP) e-consult use before and during the pandemic found that specialists’ use of virtual communications to deliver care instead of in-person recommendations increased during the pandemic because “physicians scrutinized individual cases more keenly and were not as quick to recommend a face-to-face visit.” The study reviewed IEHP’s e-consult data from February to April 2020, both before and after the issuance of California’s stay-at-home order on March 19th. The study found that the percentage of e-consults completed without a face-to-face recommendation increased from 11.1% before the stay-at-home order to 19.5% after it was issued. These results demonstrate how the pandemic has driven “clinicians to make different decisions about referrals and care coordination.”

“Electronic Consultations in Allergy/Immunology” Journal of Allergy and Clinical Immunology In Practice, November-December 2019

Researchers’ evaulation of immunology and allergy e-consults demonstrate e-consults’ ability to simplfy and streamline access to specialty care. The review of e-consults conducted between July 2016 and August 2018 found that wait times for face-to-face visits were reduced by 1.5 calendar days despite a significant overall increase in consultations. The authors conclude that the study supports e-consults’ “ability to provide expedited, problem-focused care.”

“Electronic Consults in Otolaryngology: A Pilot Study to Evaluate the Use, Content and Outcomes in an Academic Health System”Annals of Otology, Rhinology & Laryngology, October 2019

A review of an e-consult pilot at the UC San Diego Medical Center found that 82% of e-consults did not require follow-up face-to-face appointments. The authors conclude that e-consults eliminate unnecessary office visits and that its more “widespread use” should be promoted to improve the efficiency of specialty referrals.

“Electronic Consultations to Hepatologists Reduce Wait Time for Visits, Improve Communication, and Result in Cost Savings” Hepatology Communications, September 2019

The results of a retrospective study of hepatology e-consults at the University of Virgina Health Center from March 1, 2015, to May 1, 2018 demonstrates a decrease in care access from an average wait time of 68 days for face-to-face appointments to 22 hours via e-consults. The study results, which include 76% of e-consults resolved without face-to-face visits, estimate cost savings of $124 per patient.

“Simulation Tool for Evaluating Electronic Consultations in Rheumatology” IEEE Explore, December 2018

“Implementation and evaluation of Stanford Health Care store-and-forward teledermatology consultation workflow built within an existing electronic health record system” Journal of Telemedicine and Telecare, October 2018

“Can eConsults Save Medicaid?” NEJM Catalyst, August 2018

“Adoption and impact of an eConsult system in a fee-for-service setting” Healthcare, March 2017

“A cohort study of a general surgery electronic consultation system: safety implications and impact on surgical yield” BMC Health Services Research, June 2017

“Innovative Use of Electronic Consultations In Preoperative Anesthesiology Evaluation At VA Medical Centers in New England” Health Affairs, February 2018