Patient, Provider, and Clinic Characteristics of eConsults in Community-Based Health Centers

Introduction: Medically complex community-based health center (CHC) patients face barriers accessing specialty care. Electronic consultations (eConsults) could mitigate these barriers by improving CHC providers' access to specialist knowledge. We described patient, provider, and clinic characteristics of eConsult utilization in CHCs. Study Design: Analyzed electronic health record data from adult patients from April 1, 2021, to March 31, 2024. Results: Among 1,690,788 patients and 13,769 providers from 437 CHC sites (18 states), there were 20,066 eConsults (17,066 patients; 1,390 providers), with wide variation in the characteristics of patients for whom providers requested eConsults. Ten percent of providers ever requested an eConsult, with the highest rates among nurse practitioners and physicians; 73% of providers who requested an eConsult did so <10 times. eConsult documentation rates were highest in urban CHCs. Conclusions: We found substantial variation in eConsult use in CHCs. Opportunities to support specialty care access for CHC patients should be further explored.