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E-consults: an effective way to decrease clinic wait times in rheumatology.

Veena Patel1, Diana Stewart2, Molly J Horstman3,4,5

  • 1Division of Rheumatology, Department of Medicine, University of Texas at Austin, Dell Medical School, 1601 Trinity St., Bldg B, Stop Z0900, Austin, TX 78712 USA.

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Summary
This summary is machine-generated.

Electronic consults (E-consults) effectively manage positive antinuclear antibody (ANA) referrals, reducing wait times for rheumatology appointments without significantly increasing resource use.

Keywords:
Quality improvementReferral and consultationRheumatologyTelemedicine

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Area of Science:

  • Rheumatology
  • Health Informatics
  • Healthcare Management

Background:

  • Positive antinuclear antibody (ANA) referrals require timely rheumatology evaluation.
  • Assessing the impact of electronic consults (E-consults) on referral management is crucial.

Purpose of the Study:

  • To evaluate the effect of E-consults on wait times for positive ANA referrals.
  • To assess resource utilization for positive ANA referrals managed via E-consults compared to traditional in-person visits.

Main Methods:

  • A pre-post study design was employed to analyze referrals before and after E-consult implementation.
  • Statistical process control charts were used to monitor wait times for in-person rheumatology visits.
  • Retrospective review of 139 positive ANA referrals from January 2015 to March 2017.

Main Results:

  • E-consults managed 44% of positive ANA referrals post-implementation, with 76% not requiring a subsequent in-person visit.
  • A temporal association was observed between E-consult implementation and decreased wait times for in-person visits.
  • Most patients (73%) did not receive a rheumatologic diagnosis; E-consults showed a trend towards increased lab utilization, while in-person visits significantly increased imaging studies.

Conclusions:

  • E-consults provide an effective strategy for managing positive ANA referrals in rheumatology.
  • E-consult implementation was temporally linked to reduced wait times for in-person appointments.
  • This approach addresses consults efficiently with no significant increase in overall resource utilization.