Electronic consults for improving specialty care access for veterans

Area of Science:

• Cardiology
• Health Services Research
• Digital Health

Background:

• Outpatient cardiology clinics often face long wait times for new patient appointments.
• Referral management processes can be inefficient, contributing to delays in patient care.

Purpose of the Study:

• To evaluate the effectiveness of implementing e-consults within an active referral management (ARM) process.
• To reduce clinic wait times in a Veterans Health Administration (VHA) outpatient cardiology clinic.

Main Methods:

• A prospective multiphase cohort study was conducted.
• The active referral management (ARM) process involved reviewing and triaging incoming consult requests.
• Requests were directed to either an e-consult or a traditional clinic visit.

Main Results:

• Median wait time decreased from 24 days to 13 days, a 46% reduction.
• Approximately 60% of incoming consults were successfully managed via e-consults.
• E-consults were effective for managing stable diseases and minor symptoms.

Conclusions:

• E-consults integrated into an ARM process are effective in reducing wait times for outpatient cardiology services.
• The majority of clinical referrals can be managed through e-consults, avoiding the need for in-person visits.
• This strategy improves efficiency in VHA cardiology clinics.