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It All Just Clicks: Development of an Inpatient E-Consult Program.

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Electronic consultations (e-consults) offer a safe and efficient way for remote hospitals to access subspecialty expertise. This study shows hospitalists found e-consults beneficial for inpatient care.

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Area of Science:

  • Healthcare Management
  • Medical Informatics
  • Hospital Operations

Background:

  • Electronic consultations (e-consults) are common in outpatient settings but underutilized for inpatient care.
  • Hospitalists often face limited options: time-intensive in-person consults or informal curbside consults.
  • A need exists for efficient subspecialty support in remote inpatient facilities.

Purpose of the Study:

  • To develop and evaluate an electronic consultation (e-consult) protocol for a remote inpatient setting.
  • To assess the safety, efficiency, and satisfaction associated with inpatient e-consults.

Main Methods:

  • Implementation of an e-consult protocol at a new, remote hospital.
  • Tracking the number and types of e-consults over one year.
  • Conducting chart review audits and monitoring incident reports for safety.
  • Surveying hospitalists and consultants regarding satisfaction and recommendation quality.

Main Results:

  • 143 e-consults were completed in the first year, with top specialties including infectious disease, hematology, endocrinology, nephrology, and cardiology.
  • No safety issues were identified through chart audits or incident reporting in the initial period.
  • Hospitalists reported high satisfaction with the quality of e-consult recommendations (universal satisfaction).
  • Consultant agreement with recommendations was lower, at 43%.

Conclusions:

  • Inpatient e-consults can be safely and efficiently implemented in remote hospital settings.
  • Careful patient selection is crucial for successful e-consult deployment.
  • E-consults provide valuable subspecialty expertise, improving inpatient care delivery.