The following is a summary of “Impact of eConsults on Clinical Care in Primary Care: A Cross-Sectional Analysis of Primary Care Provider Behavior,” published in the September 2023 issue of Primary Care by Bifulco, et al.
Asynchronous electronic consultations (eConsults) support primary care providers (PCPs) by offering swift specialist feedback, enhancing medically underserved patients’ access to healthcare. For a cross-sectional study, researchers sought to assess all eConsults requested over one year at a multi-site federally qualified health center in Texas.
The study examined the content and quality of eConsults and conducted chart reviews for a randomly selected subsample (n = 100) to determine if PCPs implemented the recommendations from specialists within 90 days. Furthermore, semi-structured interviews with PCPs were conducted to evaluate their ability and willingness to follow these recommendations.
A total of 367 eConsults were submitted by 25 PCPs, spanning 15 adult medical and surgical specialties. Out of the 100 charts reviewed, 77 (77.0%) contained documentation indicating that the PCPs had followed at least one specialist’s recommendations within 90 days. The reviewing specialist suggested that a face-to-face referral was unnecessary in two-thirds of the cases (n = 66, 66%). PCPs were most likely to adhere to recommendations regarding new medications but were less likely to document obtaining additional patient history. Challenges in following recommendations included patients’ financial constraints or limited access to treatment, patients not returning for follow-up care, or when PCPs felt that the specialist did not adequately address their specific question.
eConsults delivered to medically underserved patients in primary care contribute significantly to PCPs’ ability to provide timely care for their patients. PCPs used a wide array of eConsult specialties and generally implemented the recommendations provided by eConsult specialists within the 90-day timeframe.