Pathology perspective on gynaecologic malignancy screening questions in electronic consultation

Area of Science:

• Gynaecology
• Oncology
• Digital Health

Background:

• Electronic consultation (eConsult) platforms facilitate asynchronous provider-to-provider specialist communication.
• This study examines eConsult utilization for gynaecologic malignancy screening, focusing on pathology inquiries.

Purpose of the Study:

• To describe primary care providers' use of eConsult for gynaecologic cancer screening.
• To identify primary care providers' uncertainties and gaps in current screening guidelines.
• To explore the role of pathology consultants within the eConsult platform.

Main Methods:

• Retrospective review of obstetrics/gynaecology eConsults (September 2011 - December 2016).
• Inclusion of all questions related to gynaecologic cancer screening and pathologies.
• Analysis of primary care provider exit surveys to assess impact on patient care, referrals, satisfaction, and education.

Main Results:

• 329 eConsults met inclusion criteria from 1,357 total submissions.
• Key inquiries involved screening indications (36%) and test intervals (17%).
• 38% of providers avoided specialist referrals; 47% received new courses of action. Pathology interpretation was a minor component (5%).

Conclusions:

• Primary care providers express uncertainty regarding gynaecologic cancer screening, highlighting gaps in existing guidelines.
• The eConsult platform effectively influences primary care provider decision-making and referral patterns.
• The utility of pathology consultants via eConsult warrants further exploration and potential integration into practice.