Keeping care connected: e-Consultation program improves access to nephrology care.

Area of Science:

• Health Services Research
• Nephrology
• Digital Health

Background:

• Health systems face challenges in improving access to specialty care.
• Electronic consultations (eConsults) offer a method for specialists to advise primary care providers (PCPs) remotely.
• eConsults facilitate clinical recommendations based on patient chart review, bypassing traditional face-to-face visits.

Purpose of the Study:

• To evaluate a nephrology eConsult pilot program in an academic primary care setting.
• To compare referral wait times and completion rates between traditional referrals and eConsults.
• To assess primary care provider satisfaction with the eConsult program.

Main Methods:

• Implementation of a nephrology eConsult pilot program.
• Analysis of primary care referral data to compare traditional referrals and eConsults.
• Surveying PCPs to gauge satisfaction with the eConsult system.

Main Results:

• eConsults demonstrated a median response time of one day and a 100% completion rate, compared to 51 days and 40.9% for traditional referrals.
• 67.5% of eConsults obviated the need for a face-to-face visit.
• PCPs reported high satisfaction, citing rapid turnaround time as a key benefit.

Conclusions:

• The nephrology eConsult pilot program successfully reduced wait times and increased referral completion.
• eConsults show significant potential for improving specialty care access in integrated health systems.
• This approach can optimize specialist caseloads and reduce unnecessary in-person appointments.