Electronic Consultations in Allergy/Immunology.

Area of Science:

• Allergy and Immunology
• Health Informatics
• Digital Health

Background:

• Allergic condition management often necessitates allergist expertise, yet access to necessary allergy testing can be limited during initial consultations.
• Electronic consultations (e-consults) have demonstrated efficiency and cost-effectiveness in other medical fields but remain understudied in Allergy/Immunology.

Purpose of the Study:

• To evaluate the utilization and impact of e-consults within an academic Allergy/Immunology practice.
• To describe the characteristics of e-consults, including volume, indications, and outcomes.

Main Methods:

• A retrospective review of e-consult and in-person consult data from August 2016 to July 2018.
• Comparison of consult volume, referral reasons, and wait times using chi-square tests.

Main Results:

• E-consults increased from 1% to 10% of new consults, with a median completion time of 11 minutes and turnaround time of 22 hours.
• E-consults were predominantly used for adverse drug reactions (66%), particularly penicillin allergy, and immunodeficiency (15%).
• Implementation of e-consults correlated with a decrease in median in-person consult wait times by 1.5 days.

Conclusions:

• E-consults are increasingly adopted in Allergy/Immunology, especially for drug allergies and immunodeficiency.
• The e-consult model effectively provides expedited, problem-focused care, reducing wait times despite increased overall consult volume.