Impact of Pediatric Electronic Consultations in a Federally Qualified Health Center
Publication: Telemedicine and e-Health
Volume 27, Issue Number 12
Abstract
Background: Access to pediatric specialty care is a challenge, particularly for medically underserved populations.
Introduction: One evolving method that has shown promise in helping ameliorate this disparity is electronic consultations (e-consults).
Materials and Methods: This retrospective cohort study compared two groups: patients referred to pediatric cardiology, endocrinology, or pulmonology from a Federally-Qualified Health Center 10 months before the implementation of an evidence-based care pathway and those referred in the 10 months after implementation. The care pathway included evidence-based referral guidelines for common pediatric diagnoses and an e-consult process. Data included patient demographics, dates of referral requests, appointment dates, e-consult response dates and times, diagnosis codes, and consultants' recommendations.
Results: Twenty-three percent of all referrals made postimplementation were submitted for an e-consult, with 53% preventing an unnecessary face-to-face visit. The most common reason for an e-consult was heart murmur/chest pain for cardiology, short stature for endocrinology, and asthma for pulmonology.
Discussion: Providers used e-consults for nearly one-quarter of all consultations postimplementation, resulting in 17% of consultations not needing a face-to-face visit. The use of e-consults combined with evidence-based referral guidelines provided a useful tool to help front line pediatric primary care providers manage complex problems and identify those not needing to see a specialist in person.
Conclusions: Evidence-based care pathways combined with e-consults can help improve access to pediatric specialty care by reducing demand for in-person visits and allowing more care to be delivered in primary care.
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Information & Authors
Information
Published In
Telemedicine and e-Health
Volume 27 • Issue Number 12 • December 2021
Pages: 1379 - 1384
PubMed: 33719584
Copyright
Copyright 2021, Mary Ann Liebert, Inc., publishers.
History
Published online: 13 December 2021
Published in print: December 2021
Published ahead of print: 12 March 2021
Accepted: 23 December 2020
Received: 11 September 2020
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Disclosure Statement
A.P. serves as a research consultant for the Community eConsults Network. W.C. and K.W. declare that they have no conflict of interest. K.R. serves as an endocrinologist at Connecticut Children's Specialty Group. G.M. serves as the business integration coordinator for the Community eConsults Network. D.A. is the director of the Community eConsults Network.
Funding Information
No funding was received for this article.
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