eConsultations to Infectious Disease Specialists: Questions Asked and Impact on Primary Care Providers’ Behavior

Ruchi Murthy · Gregory Rose · Clare E. Liddy · Amir Afkham

21 citations0/0 files storedOpen Forum Infectious Diseases

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Healthcare Systems and Technology Electronic Health Records Systems Telemedicine and Telehealth Implementation

Abstract

BACKGROUND: Since 2010, the Champlain BASE (Building Access to Specialist Advice through eConsultation) has allowed primary care providers (PCPs) to submit clinical questions to specialists through a secure web service. The study objectives are to describe questions asked to Infectious Diseases specialists through eConsultation and assess impact on physician behaviors. METHODS: eConsults completed through the Champlain BASE service from April 15, 2013 to January 29, 2015 were characterized by the type of question asked and infectious disease content. Usage data and PCP responses to a closeout survey were analyzed to determine eConsult response time, change in referral plans, and change in planned course of action. RESULTS: Of the 224 infectious diseases eConsults, the most common question types were as follows: interpretation of a clinical test 18.0% (41), general management 16.5 % (37), and indications/goals of treating a particular condition 16.5% (37). The most frequently consulted infectious diseases were as follows: tuberculosis 14.3% (32), Lyme disease 14.3% (32), and parasitology 12.9% (29). Within 24 hours, 63% of cases responded to the questions, and 82% of cases took under 15 minutes to complete. In 32% of cases, a face-to-face referral was originally planned by the PCP but was no longer needed. In 8% of cases, the PCP referred the patient despite originally not planning to make a referral. In 55% of cases, the PCP either received new information or changed their course of action. CONCLUSIONS: An eConsult service provides PCPs with timely access to infectious disease specialists' advice that often results in a change in plans for a face-to-face referral.

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2015Electronic consultations (e-consults) to improve access to specialty care: A systematic review and narrative synthesis 2016Electronic consultation systems: worldwide prevalence and their impact on patient care—a systematic review 2010Evaluating Electronic Referrals for Specialty Care at a Public Hospital 2010Electronic consultation as an alternative to hospital referral for patients with chronic kidney disease: a novel application for networked electronic health records to improve the accessibility and efficiency of healthcare 2016What are the cost savings associated with providing access to specialist care through the Champlain BASE eConsult service? A costing evaluation 2011Implementation of an electronic referral system for outpatient specialty care.2016Analysis of an electronic consultation program at an academic medical centre: Primary care provider questions, specialist responses, and primary care provider actions 2015Perspectives of Champlain BASE Specialist Physicians: Their Motivation, Experiences and Recommendations for Providing eConsultations to Primary Care Providers

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