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Modernizing the Otolaryngology Referral Workflow: The Impact of Electronic Consultation
Eliezer C Kinberg1, Diana N Kirke1,2, Samuel J Trosman1,2
1Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A.
Insights
Electronic consultation significantly improved otolaryngology clinic workflow by reducing wait times and appointment cancellations. This enhances efficiency in patient care.
Area of Science:
- Otolaryngology
- Healthcare Management
- Health Informatics
Background:
- Otolaryngology clinics face challenges with workflow efficiency and patient wait times.
- Optimizing referral and scheduling processes is crucial for high-volume public hospitals.
Purpose of the Study:
- To evaluate the impact of implementing electronic consultation (EC) on otolaryngology clinic workflow.
- To assess changes in clinic volume, referral patterns, and scheduling efficiency.
Main Methods:
- Retrospective observational study analyzing operational data from a 9-month pre-EC period (2018) and a 9-month post-EC period (2019).
- Key metrics included referral volume, appointment scheduling rates, time to evaluation, and appointment cancellation rates.
Main Results:
- Referral volume increased post-EC (4,249 vs. 3,243).
- The percentage of scheduled appointments decreased (61% vs. 86%), but the percentage of patients seen within 30 days significantly increased (53.6% vs. 24.5%).
- Average wait time decreased from 60.8 to 42.8 days, and appointment cancellations dropped by 50%.
Conclusions:
- Electronic consultation implementation led to significant reductions in patient wait times and appointment cancellations.
- EC is a valuable tool for enhancing the efficiency and effectiveness of otolaryngology clinics.
Objectives/Hypothesis:
To determine the impact of electronic consultation on the otolaryngology clinic workflow at our high-volume public hospital.
Study Design:
Retrospective Observational Study.
Methods:
This is a retrospective observational analysis study. Operational data regarding clinic volume, referral patterns, and scheduling efficiency were assessed over a 9-month period in 2018 prior to implementation of electronic consultation. The same data were collected for the 9-month period immediately following implementation of electronic consultation in 2019.
Results:
During the pre-implementation (pre-EC) period, 3,243 otolaryngology referrals were made as compared to 4,249 post-implementation (post-EC). 86% of referrals were scheduled for a clinic appointment pre-EC, compared to 61% post-EC (P < .00001) 24.5% of patients were evaluated within 30 days pre-EC compared to 53.6% post-EC (P < .00001). The average time to be seen by an otolaryngology provider declined from 60.8 days pre-EC to 42.8 days post-EC (P = .0029). There was a 50% decline in the percentage of appointments canceled by patients in the post-EC period as compared to pre-EC.
Conclusions:
In our experience, implementation of electronic consultation significantly reduced both wait times for a clinic appointment and the percentage of no-show or canceled appointments. Electronic consultation may be a valuable tool in improving the efficiency and yield of the modern otolaryngology clinic.
Level Of Evidence:
4 Laryngoscope, 131:E1792-E1796, 2021.
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