Electronic Consults in Otolaryngology: A Pilot Study to Evaluate the Use, Content, and Outcomes in an Academic Health System

Abstract

Objectives: To categorize the primary reasons for electronic consults (eConsults) to otolaryngology from primary care physicians (PCPs). To determine how many patients avoided subsequent in-person otolaryngology office visits. Methods: This is a retrospective analysis of a pilot study that took place between 2016 and 2017 regarding eConsults to adult otolaryngology placed by primary care physicians at the University of California, San Diego (UCSD) Medical Center. The complaints were categorized as related to the following: ear, nose, throat or neck. Initial recommendations were classified as (1) providing education only (no intervention), (2) suggesting medical therapy provided by the PCP, or (3) suggesting surgical intervention. Univariate statistics and multinomial logistic regression were used to analyze the association of problem type with the need for follow-up in the otolaryngology offices. The data was analyzed for differences in patient age and gender. Results: The study population included 64 patients (average age 54.6 years, 60.9% male). Within this group, 41% of consults were for ear complaints, 15% for nose complaints, 28% had throat-related complaints, and 16% had neck-related complaints. In-person follow-up was not required for 82.8% of the consults. Overall, 76.9% of ear, 100% of nose, 88.9% of throat, and 70.0% of neck complaints did not require in-person visits. Conclusions: eConsults to otolaryngology were primarily for ear concerns. Of the eConsults, 82.4% did not require in-person follow-up. We therefore conclude that the use of eConsults prevented substantial office visits that would not otherwise be necessary. Efforts should be made to promote the widespread use of eConsults, which may to the more efficient use of resources.

Incorporation of telemedicine by rhinologists: The COVID-19 pandemic and beyond

“…Perhaps this is not surprising, as the potential for telemedicine in otolaryngology has been studied in other settings in the past. Gilani [ 11 ] and McCool [ 12 ] have both examined otolaryngologists and found a variety of complaints may be appropriate for telemedicine visits; both groups noted that ear-related complaints were most amenable. Expansion of telemedicine services has been suggested for enhancing the care of Veterans Affairs (VA) patients with sleep disorders [ 13 ].…”

COVID-19 and rhinology: A look at the future

“…There have been numerous studies demonstrating that Otolaryngology is amenable to telemedicine consultation. Gilani et al performed telemedicine consultation on patients with ear-related complaints and found that more than 80% did not even require inperson followups [4]. Another analysis noted patients with ear problems were also most appropriate for telemedicine [5].…”

Otolaryngology Practice in Covid 19 Era: A Road-Map to Safe Endoscopies

“…Otolaryngology as a field has been found suitable for tele-consultation practices. Gilani et al have reported that upto 80% of patients with ear complaints who underwent telemedicine consultation never required in person follow up visits [ 3 ]. According to McCool et al too, patients with ear complaints were more suited for tele-consultation [ 4 ].…”