Electronic Consultations for Endocrine Conditions: A Scoping Review.

Abstract

Electronic consultations (e-consults) are a mode of referral increasingly used to provide access to endocrine specialty care without the need for a patient in-person visit. This scoping review aimed to describe the models being used to deliver endocrine care via e-consult, what is known about outcomes of endocrine e-consult, and research gaps. The review was completed using an established methodological framework. PubMed, Embase, CINAHL, and Cochrane were searched for articles published in English between January 1, 2000, and March 21, 2024, that reported on e-consults for endocrine specialty care. The database search yielded 2522 articles, of which 19 underwent data extraction and synthesis. The overall body of endocrine e-consult literature is small and largely observational. Various models for endocrine e-consult programs exist. Findings on feasibility, acceptability, and timeliness are positive and consistent with the larger body of e-consult literature. Data on outcomes are limited but suggest that e-consults are no worse than other referral approaches to lowering A1C. Improvements in outcomes are greater for patients whose primary care providers implement e-consult recommendations. In summary, existing studies support the benefits of e-consults in various aspects of endocrine care quality, but the literature is nascent and there are significant research gaps. Future research should examine how e-consults can best address specific endocrine conditions, with a broad set of outcomes that addresses multiple quality dimensions. Advanced study designs and qualitative methods can help address unresolved questions about e-consults relevant to all specialties, including impact on care coordination and costs and best practices for reimbursement and workflow.