Use of an E-mail curbside consultation service by family physicians

Informal (curbside) consultations are central to clinical medicine. Typically, these exchanges between health professionals occur face-to-face or by telephone, but both of these methods can be inefficient. We created an electronic mail (E-mail) service for curbside consultations between family physicians and other health care specialists at an academic medical center.

Family physicians had access to the E-mail Consult Service (ECS) from 20 computers at three office practice sites, one hospital, and their personal offices. Informal consults could be obtained from 26 different consultants at the University of Iowa using standard E-mail. Data on the content of the consults and the use of this service were collected and both family physicians and consultants were questioned about their perceptions of the service.

In the 18 months that the service was available, the ECS handled 237 consults. The median response time for a consult by using the service was 16.1 hours. Consultations in the area of adult medicine were the most common, followed by consults in obstetrics and gynecology. Nearly 90% of the consults were about a specific patient, and the majority of the questions were about management issues. Consultants answered 92% of the questions asked by family physicians using the ECS. Family physicians reported that this service was helpful, and most consultants reported that they enjoyed E-mail curbside consults.

E-mail was successfully used for curbside consults. Both the family physicians and consultants found that an E-mail consultation service could be integrated into their practices.