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E-Patient Counseling Trial E-PACO: Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy

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Understanding suboptimal e-consult requests: lessons from the VA.

Ekaterina Anderson¹, Ariella Krones, Varsha G Vimalananda

¹Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, 200 Springs Rd, Bedford, MA 01730.

The American Journal of Managed Care

|January 3, 2024

Summary

This summary is machine-generated.

Clinicians desire focused electronic consultations (e-consults) but face challenges due to EHR limitations and differing expertise. Improving e-consult quality requires addressing these systemic issues for better collaboration.

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Area of Science:

Health Services Research
Clinical Informatics
Medical Quality Improvement

Background:

Electronic consultations (e-consults) are increasingly utilized in healthcare systems for specialist advice without direct patient contact.
Understanding clinician perspectives on e-consult quality is crucial for optimizing their use.

Purpose of the Study:

To identify primary care clinicians' (PCCs) and specialists' views on the quality of e-consult requests.
To explore factors contributing to perceived suboptimal e-consult requests.

Main Methods:

Qualitative study conducted at the US Department of Veterans Affairs (VA) New England Healthcare System.
Thematic analysis of interviews with 35 PCCs and 38 specialists across cardiology, neurology, and pulmonology.

Main Results:

Both PCCs and specialists agreed that e-consults should be focused, concise, and include sufficient preliminary data.
Specialists reported frustration with e-consult requests, citing EHR interface issues, differing expertise, and organizational pressures as key barriers.

Conclusions:

Clinician perspectives highlight the need to address EHR limitations and inter-professional communication gaps to improve e-consult quality.
Findings offer transferable insights for health systems aiming to enhance clinician collaboration and care coordination through e-consults.