What makes a high-quality electronic consultation (eConsult)? A nominal group study.

Area of Science:

• Health Informatics
• Medical Communication
• Quality Improvement

Background:

• Poor communication among health professionals can endanger patient safety.
• Electronic consultation (eConsult) services are increasingly used, but effective communication strategies for specialists advising primary care providers (PCPs) are not well understood.
• There is a need to define high-quality eConsult communication to improve specialist feedback and patient care.

Purpose of the Study:

• To identify features of high-quality eConsult advice.
• To develop an assessment tool for providing feedback to specialists on their eConsult correspondence.
• To enhance communication quality in eConsult services.

Main Methods:

• The nominal group technique (NGT) was used to generate initial items for the assessment tool.
• Primary care providers (PCPs) and specialists participated in consensus-based discussions and rankings.
• Items were included if highly ranked by over 70% of participants.

Main Results:

• Fourteen key features of high-quality eConsult advice were identified from an initial 49 items.
• Effective eConsult advice is specific, up-to-date, patient-individualized, and practical for PCPs.
• Consensus methods highlighted similarities and differences between eConsults and traditional consultation letters.

Conclusions:

• The identified features of high-quality eConsult communication can inform the development of feedback and education for specialists.
• Implementing an assessment tool based on these findings can improve the quality of eConsult advice.
• Enhanced communication via eConsult has the potential to improve patient safety and primary care.