Formalizing the curbside: digitally enhancing access to specialty care

Area of Science:

• Health Informatics
• Medical Systems Engineering
• Digital Health

Background:

• Asynchronous medical care, particularly E-consults, is gaining traction due to increased patient interest and industry demand.
• Limited examples exist of multispecialty E-consult program implementation within large, integrated healthcare systems.
• This study details the implementation of an internal E-consult program designed for asynchronous, non-urgent communication between ambulatory specialists and primary care providers.

Discussion:

• Systematic efforts were made to address patient, specialist, and primary care physician concerns to ensure program adoption.
• The program initiated with cardiology, orthopedics, and dermatology, expanding to 19 specialties within the first year.
• High utilization, with 2243 E-consults ordered by 505 providers in 12 months, highlights successful integration.

Key Insights:

• The E-consult program demonstrated significant growth in its initial year, indicating strong viability.
• Dermatology received the highest number of consultations, suggesting a high demand for specialized dermatological advice.
• The expansion to 19 specialties underscores the program's scalability and broad applicability across various medical fields.

Outlook:

• The successful implementation provides a scalable model for other large healthcare systems seeking to improve specialist access.
• Future work may focus on evaluating patient outcomes and cost-effectiveness of the E-consult program.
• Continued expansion and refinement of the E-consult platform can further optimize asynchronous specialist consultations.