Clinical Trends Over the First Year of a Psychiatric Electronic Consult Service

Zemanek, Cecilia; Martin, Katherine

doi:10.1016/j.jaclp.2021.09.005

Cited by 4 publications

(6 citation statements)

References 9 publications

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“…This mixed-method study examined the nature and complexity of psychiatric cases submitted to the Prisma platform for review by a psychiatrist. Cases were fairly well balanced by sex and age, and they covered a variety of psychiatric problems and enquiry types, alike other studies (17,18). Most cases received a response within 1 day, which is in line with earlier research (15,17,19), all showing a seemingly rapid response time.…”

Section: Discussionsupporting

confidence: 81%

Online Consultations Between General Practitioners and Psychiatrists in the Netherlands: A Qualitative Study

et al. 2021

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Objective: To examine the nature and scope of questions about psychiatric patient cases submitted by general practitioners (GPs) to an established online consultation platform and to determine if they could have been answered by consulting existing clinical guidelines.Methods: All anonymized psychiatric cases submitted by GPs to the online electronic Prisma platform between September 2018 and November 2019 were examined in a mixed-methods study. Descriptive statistics and qualitative thematic analysis were used, followed by axial coding to arrive at overarching themes to characterize cases.Results: Of the 136 included cases, 44.1% concerned female patients and about half concerned patients aged 31–60 years. Common psychiatric disorders were depression, attention deficit hyperactivity disorder, sleeping problems, sexual disorders, and eating disorders. The first response was usually given within 2 h (interquartile range, 0–14.3 h), with 86% answered within 24 h and 95% within 48 h. Qualitative analysis revealed four themes, namely “type of question,” “cases in relation to current clinical guidelines,” “case complexity” and “the doctor being pressured.” Type of question comprised diagnostic, therapeutic, and referral questions. Notably, for 44.1% of questions no current clinical guidelines was present and 46.3% of cases were deemed complex in nature. GPs were willing to share their experiences of coping with being pressured by patients.Conclusion: The findings of this study support the potential for an online electronic consultation platform to facilitate feasible and useful interprofessional consultation between GPs and psychiatrists for a broad range mental illnesses and questions of varying complexity.

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Section: Discussionsupporting

confidence: 81%

Online Consultations Between General Practitioners and Psychiatrists in the Netherlands: A Qualitative Study

et al. 2021

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“…– Which diagnoses and types of questions are most commonly involved in psychiatric e-consults . A recent retrospective chart review of a psychiatric e-consult service suggested that e-consult services are particularly valuable for cases involving diagnoses of depression and anxiety, and for questions about pharmacological management 24 …”

Section: Resultsmentioning

confidence: 99%

“…The studies included in this review also represented highly divergent primary care settings, limiting generalizability of any individual study. The limited number and scope of the existing peer-reviewed studies on psychiatry e-consults highlight the nascent state of the scientific literature on the topic 18–26,28,30,34 …”

Section: Resultsmentioning

confidence: 99%

“…A recent retrospective chart review of a psychiatric e-consult service suggested that e-consult services are particularly valuable for cases involving diagnoses of depression and anxiety, and for questions about pharmacological management. 24 -What guidelines might be established for staffing, competencies, and implementation of psychiatric e-consults by the members of the interdisciplinary team. A recent scoping review has identified potential skills and competencies that might be needed for clinicians and trainees to provide quality care asynchronously in medicine and psychiatry; substantial additional research is needed, however, to further develop, implement, and evaluate those competencies.…”

Section: Potential Factors Affecting E-consult Adoption and Usementioning

confidence: 99%

“…The limited number and scope of the existing peerreviewed studies on psychiatry e-consults highlight the nascent state of the scientific literature on the topic. [18][19][20][21][22][23][24][25][26]28,30,34 Most critically, the impact of e-consult on patient outcomes, such as psychiatric symptoms, quality of life, and functioning, needs to be assessed. Such studies would ideally compare e-consults to direct evaluation and management by psychiatrists (whether in-person or virtually) or other models of integrated psychiatric care, such as the collaborative care model.…”

Section: Limitations Of This Studymentioning

confidence: 99%

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The Practice of Psychiatric E-Consultation: Current State and Future Directions

Adams

Lim

Huang

2022

Harv Rev Psychiatry

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ObjectiveThis article summarizes the existing literature on psychiatric electronic consultation (e-consultation or e-consult) to provide guidance on psychiatric e-consult practice and suggest next steps in research on psychiatric e-consults.MethodA narrative review was conducted using relevant search terms in PubMed and Google Scholar.Results and DiscussionThe psychiatric e-consult is a method of asynchronous consultation between primary care providers and psychiatric specialists that is associated with primary care provider satisfaction and promotes access to specialist guidance in mental health care. Major themes in the literature include contextual factors that affect implementation of psychiatric e-consult services, outcomes associated with psychiatric e-consults, and specific practical considerations that may affect psychiatric e-consult technique.ConclusionsPsychiatric e-consults may help address the widespread lack of access to specialty psychiatric care. Further studies are needed to examine clinical outcomes based on psychiatry e-consults.

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