An Integrated Kidney Care eConsult Practice Model: Results from the iKinect Project

Area of Science:

• Nephrology
• Health Informatics
• Healthcare Management

Background:

• Siloed care in kidney disease management leads to diagnostic and treatment delays, inefficient resource use, and provider/patient dissatisfaction.
• Digital systems like eConsult offer a solution for collaborative management, improving communication between primary care physicians (PCPs) and nephrologists.
• An established eConsult platform with central triage was evaluated for its role in managing kidney disease.

Purpose of the Study:

• To assess the acceptability and feasibility of an eConsult platform for kidney disease management.
• To determine the impact of eConsult on access to nephrology care compared to traditional referrals.
• To evaluate physician experiences with the eConsult system.

Main Methods:

• A 1-year pilot study using mixed methods was conducted.
• Data on consultation types, referrals, and response times were compared between eConsult and traditional referrals.
• Semi-structured interviews were performed with participating PCPs and nephrologists.

Main Results:

• The study included 52 PCPs and 23 nephrologists, with 106 eConsults and 250 traditional referrals.
• eConsults had a median response time of 15 hours, significantly faster than the 4-month median wait for a traditional referral appointment.
• Physician interviews indicated high satisfaction with eConsults, citing efficiency and timely responses.

Conclusions:

• The eConsult platform is an acceptable and feasible tool for improving access to nephrology care.
• eConsult integration enhances physician care delivery, addresses nephrology care gaps, improves patient experience, and optimizes healthcare utilization.