The following is a summary of “Impact of eConsults on Clinical Care in Primary Care: A Cross-Sectional Analysis of Primary Care Provider Behavior,” published in the September 2023 issue of Primary Care by Bifulco, et al.

Asynchronous electronic consultations (eConsults) play a vital role in supporting primary care providers (PCPs) by offering prompt specialist insights, thereby enhancing access to care for medically underserved patients. For a cross-sectional analysis, researchers investigated a year’s worth of eConsults at a multi-site federally qualified health center in Texas. The primary objectives were to examine the content and quality of eConsults and to evaluate whether PCPs implemented the recommendations provided by specialists within 90 days. Additionally, semi-structured interviews with PCPs were conducted to gauge their capacity and willingness to follow these recommendations.

A total of 367 eConsults were submitted by 25 PCPs spanning 15 adult medical and surgical specialties. For a random subsample of 100 cases, chart reviews were conducted to ascertain whether PCPs had incorporated specialist recommendations within the stipulated 90-day period. The study also explored the content and quality of these eConsults. Semi-structured interviews were conducted with PCPs to gauge their ability and willingness to adhere to specialist recommendations.

Among the 100 charts reviewed, 77 (77.0%) showed documented evidence that PCPs had followed at least one of the specialist’s recommendations within 90 days. In two-thirds of these cases (66%), reviewing specialists indicated that a face-to-face referral was unnecessary. PCPs were most inclined to follow recommendations regarding new medications but were less likely to document obtaining additional patient history. PCPs cited reasons such as patient affordability, accessibility to treatment, patient follow-up care, and perceived inadequacy in addressing their specific queries by specialists as hindrances to following recommendations.

eConsults, particularly for medically underserved patients in primary care, play a pivotal role in assisting PCPs in delivering timely care. PCPs engaged a wide array of eConsult specialties and generally adhered to specialists’ recommendations within the stipulated 90-day timeframe.

Source: journals.sagepub.com/doi/full/10.1177/21501319231202201