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Triage to Advice Only for Referring Providers: A Pilot Project Using Formal Consensus Methods to Establish
Heather Lochnan1,2, Geetha Mukerji3,4,5,6,7, Erin Keely1,2
1Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
AACE Endocrinology and Diabetes
|December 30, 2025
Summary
Endocrinologists can now use eConsultation for many referral scenarios, improving timely advice and reducing wait times. This study established consensus on appropriate cases for virtual consultations, enhancing care efficiency.
Area of Science:
- Endocrinology
- Health Services Research
- Digital Health
Background:
- Access to timely endocrinology consultations is a significant challenge.
- Inefficient referral pathways contribute to prolonged patient wait times.
- Optimization of endocrinology referral processes is needed.
Purpose of the Study:
- To achieve consensus among endocrinologists on referral scenarios suitable for eConsultation.
- To assess the consistency of eConsultation suitability across different endocrinology divisions.
- To identify specific clinical scenarios appropriate for advice-only virtual consultations.
Main Methods:
- Nominal group technique used to generate clinical scenarios.
- Modified Delphi process employed to gauge expert agreement on eConsultation suitability.
- Independent consensus-building rounds conducted across two academic endocrinology divisions.
Main Results:
- High consensus achieved at both sites regarding eConsultation suitability.
- Site 1: 78% consensus, with 38 scenarios deemed appropriate for eConsultation.
- Site 2: 83% consensus, with 34 scenarios deemed appropriate for eConsultation; minimal discordance between sites.
Conclusions:
- A high degree of consensus exists for utilizing eConsultation in endocrinology.
- Consensus on appropriate eConsultation scenarios facilitates consistent clinical decision-making.
- This approach supports efficient triage of ambulatory care endocrinology referrals.
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