A unique assessment of e-consults between primary care providers and radiologists demonstrates patient benefits, lowered costs as well as improved primary care provider knowledge. Among the 307 e-consults reviewed, 55% resulted in patient management changes and 28% included the avoidance of unneeded imaging tests. In addition, 75% of the primary care providers reported e-consult excellence highlighting the important role radiologists play in patient care coordination.
“Utility, Appropriateness, and Content of Electronic Consultations Across Medical Subspecialties: A Cohort Study” Annals of Internal Medicine, May 2020
For a cohort study of Partners HealthCare System’s e-consult program, researchers developed novel metrics to assess econsults’ utility, appropriateness and content. The study, which included hematology, infectious disease, dermatology, rheumatology, and psychiatry e-consults from October 2017 to November 2018, found the following results:
- Across all specialties, most e-consults were completed within 1 day or less (range: 73.1% for psychiatry to 87.8% for infectious disease)
- From 84 geographic locations, most referring providers were physicians (79.0%) and PCPs (75.8%), and most were affiliated with tertiary care practices (83.2%)
- 70% of e-consults were deemed appropriate based on review of patient records
The study’s authors conclude: “We found high rates of appropriate e-consults across specialties, supporting the hypothesis that e-consults are an efficient care model compared with in-person visits.” To learn more, view the E-Consult Workgroup Webinar research presentation by lead author Salman Ahmed, MD, MPH of Brigham and Women’s Hospital and Harvard T.H. Chan School of Public Health.
To determine patient safety of e-consult use in vascular surgery, researchers conducted a retrospective study of Ann Arbor Veterans Affairs Healthcare System’s e-consult use between October 2012 and November 2015. The study, which collected data on adverse outcomes up to 1 year after consultation and data on all-cause mortality at 1 year and 5 years, found that “eConsults provide a safe and effective means of triaging and providing recommendations for patients with vascular disease.”
“Association of a Remotely Offered Infectious Diseases eConsult Service With Improved Clinical Outcomes” Open Forum Infectious Diseases, January 2020
The first study of e-consult use for infectious disease (ID), conducted by The Mayo Clinic, reports a 70% decrease of 30-day mortality rates. The study assessed ID e-consult use by two small, rural Mayo Clinic Health System (MCHS) hospitals and compared the data to matched control data from 18 other hospitals. The study also surveyed hospitalists and ID specialists who reported high satisfaction with their e-consults for 100 patients.
“eConsults: An emerging tool to help advance the patient-centered medical home” Becker’s Health IT, August 2018
“Cardiology electronic consultation (e-consult) use by primary care providers at VA medical centres in New England” Journal of Telemedicine and Telecare, May 2018
A study of 750 VA New England Health System’s patient medical charts revealed that while primary care providers are the most frequent requesters of cardiology e-consults cardiologists only answer one in ten e-consults because of insufficient clinical information. The study concludes that educating PCPs and standardizing e-consult templates may help reduce the number of unanswered e-consults.
“Electronic Consultations to Improve the Primary Care-Specialty Care Interface for Cardiology in the Medically Underserved: A Cluster-Randomized Controlled Trial” Annals of Family Medicine, March/April 2016
“Transforming the endocrine consult: asynchronous provider consultations.” Endocrine Practice, February 2015