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Improving Access to Rheumatology Care: Evaluation of a Rheumatology Electronic Consultation Program.

Sarah J Billups1, Brittney R Fraumeni2, Lisa M Schilling2

  • 1Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora.

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Summary

An electronic consultation (eConsult) program improved rheumatology care access for rural patients. While efficient, further provider education is needed to maximize its impact on specialty care delivery.

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Area of Science:

  • Health Services Research
  • Digital Health
  • Rheumatology

Background:

  • Access to specialty care, particularly rheumatology, is a significant barrier for patients in rural and underserved regions.
  • Traditional referral pathways often involve long wait times and patient travel, exacerbating access challenges.
  • Electronic consultation (eConsult) platforms offer a potential solution to bridge these gaps in care delivery.

Purpose of the Study:

  • To evaluate the implementation and impact of a rheumatology eConsult program within a hospital network.
  • To assess the program's effectiveness in improving access to rheumatology care for diverse patient populations.
  • To identify key facilitators and barriers to eConsult program adoption and utilization.

Main Methods:

  • A mixed-methods approach was employed, integrating quantitative data from electronic health records and Medicaid claims.
  • Qualitative data were gathered through interviews with healthcare providers to understand their experiences with the eConsult system.
  • Analysis included patient, provider, and referral characteristics, alongside care process and utilization outcomes.

Main Results:

  • The rheumatology eConsult program handled 670 consultations between April 2018 and June 2022, with 75% resolved electronically.
  • eConsults converted to traditional referrals showed a higher 180-day completion rate (36%) compared to traditional referrals (19%).
  • Provider interviews revealed improved efficiency and reduced patient travel, but highlighted a need for greater platform familiarity and usage.

Conclusions:

  • The eConsult program demonstrates a promising strategy for enhancing specialty care access, especially for remote and underserved populations.
  • Successful integration requires ongoing provider education and robust system integration efforts to optimize its benefits.
  • Continued development and support are essential for maximizing the program's potential in improving rheumatology care delivery.