The use of eConsults to improve access to specialty care in thrombosis medicine

Electronic consultations (E-consults) and their outcomes: a systematic review

“…At the time of our 2015 review, most studies reported high PCP satisfaction with e-consults, including perceived value, improved timeliness of specialty input, and enhanced communication with specialist. Newer studies using PCP surveys support these findings, 11,13,14,[18][19][20][21][22]24,26,[29][30][31][33][34][35][36]41,54,57,60,[62][63][64][65][67][68][69][70][71] and 2 qualitative studies also report generally high PCP satisfaction. 7,39 More recent studies have also described a strong educational benefit to less-experienced PCPs.…”

“…Sleep medicine e-consultation followed by the specialists' order of a sleep study and positive airway pressure therapy, if indicated, resulted in a decrease over 4 years in the interval between sleep consult and positive airway pressure prescription from 60 days to 7 days. 38 More than a dozen studies report a response time (i.e., the time between when the e-consult is requested and when the responding specialist provides the response) of a few days or less, 11,13,14,16,20,21,28,32,34,35,40,46,47,51,56,61,62,67,69 whereas face-toface visits generally require days to weeks to be completed.…”

“…62 Several publications from the Champlain BASE program report on a PCP survey question at the end of each e-consult request about whether a face-to-face consult would have been sent in the absence of the e-consult option. Depending on specialty of the consultation being requested, 32%-80% of PCPs report that a face-to-face visit would have been required absent the e-consult, [12][13][14]16,[18][19][20][21]24,26,[28][29][30][31][32][33][34][35][36]41,47,51,58,62,65 suggesting that up to as many as 4 out of 5 e-consults are perceived to obviate a face-to-face visit. Using these data on face-to-face referrals avoided, the Champlain BASE group calculated payer costs decreasing from $131.05 to $6.45 (CAD) per econsult from year 1 to year 3 of the program.…”

Consult Management at the VA Palo Alto Health Care System

“…Similarly, in Champlain Local Health Integration Network in Ontario, Canada, "excessive wait times and unequal access to specialist services can negatively impact patient care" (Skeith, et al 2017). Skeith, et al (2017) evaluated the use of electronic consultations or eConsults in thrombosis medicine. These eConsults are also reviewed through a process of what Scheibe et al (2015) would describe as a "preconsultation exchange" between primary care provider (PCP) and specialist.…”

“…Without the proper pathway, clinics encounter barriers when successfully streamlining each consult through its entire process. VAPAHCS can benefit from an established preconsultation exchange process with eConsults or eReferrals researched by Scheibe et al (2017) and Skeith et al (2017).…”