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Area of Science:

  • Digital Health
  • Psychiatry
  • Primary Care Medicine

Background:

  • High prevalence of mental health issues in primary care settings.
  • Challenges in accessing specialist psychiatric care.
  • Electronic consultation (e-consult) shows potential for bridging this gap.

Purpose of the Study:

  • To examine the utilization of e-consults between primary care providers (PCPs) and psychiatrists.
  • To investigate PCP perceptions of psychiatric e-consults.
  • To identify strategies for optimizing e-consult utility and uptake.

Main Methods:

  • Mixed-methods study combining chart review of psychiatry e-consults (N=37) and qualitative interviews with PCPs (N=10).
  • Chart review assessed response times and referral content.
  • Interviews explored PCP experiences, perceived uses, and barriers to psychiatric e-consults.

Main Results:

  • Psychiatry e-consults represented 3.66% of all e-consults; most requests concerned medication management and symptom control.
  • High response rates within 24 hours (81%) and single-exchange resolutions (65%) were observed.
  • PCPs perceived psychiatry as complex, limiting e-consult utility beyond psychopharmacology; new and rural PCPs were more receptive.

Conclusions:

  • E-consultation is a practical and timely method for PCPs to obtain psychiatric guidance.
  • Enhancing e-consult utility and uptake necessitates integration into established care pathways.
  • Adequate preparation and education for both referrers and consultants are crucial for successful implementation.