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Electronic Consultations in Allergy/Immunology.

Neelam A Phadke1, Anna R Wolfson1, Christian Mancini2

  • 1Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Boston, Mass; Harvard Medical School, Boston, Mass.

The Journal of Allergy and Clinical Immunology. in Practice
|June 7, 2019
PubMed
Summary

Electronic consultations (e-consults) in allergy/immunology improved patient access and reduced wait times for specialist care. This digital approach offers expedited, problem-focused management for conditions like drug allergies and immunodeficiency.

Keywords:
AccessAdverse drug reactionAsynchronous allergist accessE-consultElectronic consultationImmunodeficiency evaluationQuality improvementTelehealth

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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.