Improving access to urologists through an electronic consultation service.

Area of Science:

• Urology
• Health Informatics
• Telemedicine

Background:

• Specialist access is limited by wait times and geography.
• Champlain Building Access to Specialist Advice (BASE) facilitates specialist access for primary care providers (PCPs).
• eConsults offer an alternative to formal in-office consultations via a secure web system.

Purpose of the Study:

• To analyze urology eConsults through the Champlain BASE service.
• To characterize consult types, referral avoidance, physician satisfaction, and impact on patient care.

Main Methods:

• Analysis of 190 urology eConsultations from March 2013 to January 2015.
• Characterization of clinical questions and referral content.
• Evaluation of mandatory close-out survey data on referral avoidance and physician satisfaction.

Main Results:

• 70% of eConsultations were completed in under 10 minutes.
• Common queries involved imaging interpretation (16%) and test selection (15%).
• 35% of contemplated urology referrals were avoided; 8% of initially unneeded referrals were initiated post-eConsult.

Conclusions:

• eConsultations can reduce unnecessary urology clinic visits.
• eConsults help identify patients who require early specialist consultation.
• The BASE system may improve timely access to urological expertise.