Leveraging an Electronic Consultation Program for a High-Volume Hepatology Clinic

Area of Science:

• Hepatology
• Digital Health
• Healthcare Access

Background:

• Rising chronic liver disease prevalence in the US.
• National shortage of hepatologists leading to long wait times.
• E-consults as a strategy to expand access to specialty care.

Purpose of the Study:

• Characterize contemporary hepatology e-consult use.
• Evaluate the impact of e-consults on healthcare utilization.
• Assess e-consults in the post-COVID-19 era.

Main Methods:

• Retrospective cohort study of hepatology e-consults (1/1/2021-12/31/2024).
• Extracted patient demographics, provider characteristics, clinical questions, and outcomes.
• Primary outcome: proportion of e-consults resolved without an in-person visit within 6 months.

Main Results:

• 3,011 hepatology e-consults from 663 providers across 39 specialties.
• Common concerns: abnormal liver tests (68.9%), abnormal imaging (18.5%), and metabolic-associated steatotic liver disease (12.4%).
• Median e-consult completion time: 0 days vs. 46 days for traditional referrals; 63.6% resolved without a visit, saving 137,000 miles of travel.

Conclusions:

• Hepatology e-consults effectively manage low-complexity cases in primary care.
• E-consults preserve specialty clinic capacity and reduce patient travel.
• E-consults play a key role in meeting the demand for hepatology expertise.