Electronic consultations (E-consults) and their outcomes: a systematic review

Area of Science:

• Health Services Research
• Digital Health
• Clinical Informatics

Background:

• Electronic consultations (e-consults) are growing in use for clinician-to-clinician communication.
• Limited empirical data exists on the outcomes of widespread e-consult implementation.

Purpose of the Study:

• To systematically review the literature on the effects of e-consults.
• To assess impacts on access, cost, quality, and patient/clinician experience.
• To identify research gaps in e-consult outcome evaluation.

Main Methods:

• Systematic review of peer-reviewed literature (Jan 2015 - Feb 2019).
• Searched 4 databases; dual review of titles/abstracts.
• GRADE criteria applied to assess evidence strength.

Main Results:

• Modest empirical evidence supports e-consult effectiveness.
• Most studies were observational and single-system based.
• Findings were generally positive, with mixed results for clinician experience; publication bias is a concern.

Conclusions:

• More rigorous study designs are needed to confirm e-consult benefits.
• Policy makers require clearer evidence on expected benefits and contexts.
• Further research should guide the definition of success measures for e-consult programs.