Evaluation and Utility of an Electronic Consultation Program in a Children's Health System.

Abstract

Objectives: Electronic consultations (e-consults) are asynchronous communication between Primary Care Providers (PCPs) and specialists. Studies in adults show that e-consults improve specialty access, but the data in pediatrics are limited. We report evaluation and utility of a large pediatric e-consult program.

Methods: We reviewed our database for numbers of e-consults per specialty, indications, and completion time. We determined the utility of e-consults by assessing healthcare utilization for the same clinical problem within two months following completed e-consults. PCPs and specialists were surveyed to assess time spent on e-consults, and satisfaction with the e-consult program.

Results: Thirty-four specialists from 13 specialties completed 2192 e-consults requested by 45 PCPs over 55 months. An average response time for e-consult completion was 0.8 days. Dermatology (42%), Endocrinology (16.6%) and Neurology (8.2%) were the top three specialties with rashes, puberty questions, and seizures as common indications, respectively. Within the two months, 85% of patients did not present to the clinics or the emergency room for the same clinical problems addressed in the e-consults. Time spent on the e-consult was less than 20 minutes for PCPs (80%) and specialists (77%). High satisfaction was reported in PCPs (97%) and specialists (85%) with the e-consult program.

Conclusions: In the largest study on pediatric e-consults so far, prompt specialty advice was provided with e-consults to the PCPs by specialists. In most cases, patients did not present to our health system for the same clinical problems within two months. Both PCPs and specialists reported high satisfaction with the e-consult program.