Pediatric Dermatology eConsultation in Academic Centers: A Collaborative Model for Optimized Outpatient Care

Area of Science:

• Pediatric Dermatology
• Health Informatics
• Telemedicine

Background:

• High demand for pediatric dermatology services strains academic healthcare centers.
• eConsultation programs enhance access by supporting primary care providers (PCPs).
• Assessing eConsultation utility in pediatric dermatology is crucial for optimizing care delivery.

Purpose of the Study:

• Evaluate the real-world utility of a pediatric dermatology eConsultation program.
• Analyze outcomes, diagnostic/management concordance, and completion predictors.
• Determine the effectiveness of asynchronous provider-to-provider consultations.

Main Methods:

• Retrospective cohort study of 900 outpatient pediatric dermatology eConsult referrals.
• Data collected from a tertiary academic center between 2017 and 2021.
• Analysis of eConsult completion rates, reasons for decline, and concordance metrics.

Main Results:

• 69% of eConsults were completed without requiring in-person dermatology follow-up.
• 26% of referrals were declined due to medical complexity or inadequate photos.
• Diagnostic and management concordance between PCPs and dermatologists was 78% and 67%, respectively.

Conclusions:

• Provider-to-provider eConsultation offers rapid specialist guidance for low-complexity pediatric skin conditions.
• Improved outpatient skin management by PCPs is suggested by management plan concordance rates.
• eConsultation is a valuable tool for enhancing pediatric dermatology access and care.