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Evaluating diverse electronic consultation programs with a common framework.

Delphine S Tuot1,2, Clare Liddy3,4, Varsha G Vimalananda5,6

  • 1Center for Innovation in Access and Quality at Priscilla Chan and Mark Zuckerberg San Francisco General Hospital and Trauma Center, University of California San Francisco, San Francisco, CA, 94110, USA. Delphine.tuot@ucsf.edu.

BMC Health Services Research
|October 26, 2018
PubMed
Summary
This summary is machine-generated.

Electronic consultations improve access to specialty care, but widespread adoption is limited. Developing shared evaluation metrics, based on the Quadruple Aim, can drive improvements and growth for these essential healthcare programs.

Keywords:
E-consultElectronic consultationEvaluationQuadruple aimRE-AIM

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Area of Science:

  • Healthcare Delivery Systems
  • Digital Health Interventions
  • Specialty Care Access

Background:

  • Electronic consultation (e-consult) offers specialist expertise to primary care providers and patients, bypassing in-person visits.
  • Despite demonstrated benefits in timely access, e-consult programs face limited adoption in the US.
  • Lack of standardized evaluation metrics and generalizability concerns hinder e-consult program growth.

Purpose of the Study:

  • Identify knowledge gaps in e-consult implementation.
  • Develop shared evaluation metrics to promote wider e-consult diffusion.

Main Methods:

  • Case study approach examining 4 diverse healthcare systems.
  • Utilized RE-AIM and Quadruple Aim frameworks for evaluation.
  • Collected quantitative and qualitative data from e-consult databases and end-users.

Main Results:

  • Common organizational drivers (access challenges) but varied system-level facilitators/barriers.
  • Consistent effectiveness: improved timely access to perceived high-quality specialty care with high end-user satisfaction.
  • Gaps identified in patient clinical outcomes data, legal guidance, and remuneration strategies.

Conclusions:

  • A core set of effectiveness and implementation metrics aligned with the Quadruple Aim can foster data-driven improvements.
  • Standardized metrics are crucial for promoting the diffusion of successful e-consult programs.