Advertisement

 

 

Psychiatric Consultation at Your Fingertips: Descriptive Analysis of Electronic Consultation From Primary Care to Psychiatry.

Psychiatric Consultation at Your Fingertips: Descriptive Analysis of Electronic Consultation From Primary Care to Psychiatry.
Author Information (click to view)

Lowenstein M, Bamgbose O, Gleason N, Feldman MD,


Lowenstein M, Bamgbose O, Gleason N, Feldman MD, (click to view)

Lowenstein M, Bamgbose O, Gleason N, Feldman MD,

Advertisement
Share on FacebookTweet about this on TwitterShare on LinkedIn

Journal of medical Internet research 2017 08 0419(8) e279 doi 10.2196/jmir.7921
Abstract
BACKGROUND
Mental health problems are commonly encountered in primary care, with primary care providers (PCPs) experiencing challenges referring patients to specialty mental health care. Electronic consultation (eConsult) is one model that has been shown to improve timely access to subspecialty care in a number of medical subspecialties. eConsults generally involve a PCP-initiated referral for specialty consultation for a clinical question that is outside their expertise but may not require an in-person evaluation.

OBJECTIVE
Our aim was to describe the implementation of eConsults for psychiatry in a large academic health system.

METHODS
We performed a content analysis of the first 50 eConsults to psychiatry after program implementation. For each question and response, we coded consults as pertaining to diagnosis and/or management as well as categories of medication choice, drug side effects or interactions, and queries about referrals and navigating the health care system. We also performed a chart review to evaluate the timeliness of psychiatrist responses and PCP implementation of recommendations.

RESULTS
Depression was the most common consult template selected by PCPs (20/50, 40%), followed by the generic template (12/50, 24%) and anxiety (8/50, 16%). Most questions (49/50, 98%) pertained primarily to management, particularly for medications. Psychiatrists commented on both diagnosis (28/50, 56%) and management (50/50, 100%), responded in an average of 1.4 days, and recommended in-person consultation for 26% (13/50) of patients. PCPs implemented psychiatrist recommendations 76% (38/50) of the time.

CONCLUSIONS
For the majority of patients, psychiatrists provided strategies for ongoing management in primary care without an in-person evaluation, and PCPs implemented most psychiatrist recommendations. eConsults show promise as one means of supporting PCPs to deliver mental health care to patients with common psychiatric disorders.

Submit a Comment

Your email address will not be published. Required fields are marked *

12 + 17 =

[ HIDE/SHOW ]