The following is a summary of “Primary care clinician perspectives on automated nephrology e-consults for diabetic kidney disease: a pre-implementation qualitative study,” published in the June 2024 issue of Primary Care by Chu et al.
Patients with diabetic kidney disease (DKD) often lack guideline-recommended treatment, which is essential for managing disease progression and complications. Proactive electronic consultations (e-consults) represent a novel approach that allows nephrologists to offer timely guidance to primary care providers (PCPs) involved in early DKD management.
This study aimed to investigate barriers and facilitators related to implementing a proactive e-consult program to enhance DKD care delivery. Semi-structured qualitative interviews were conducted with PCPs from three distinct health systems. Interview transcripts underwent rapid qualitative analysis to identify and refine key themes and subthemes.
Eighteen interviews were completed, revealing consistent challenges among PCPs in adhering to DKD care guidelines. PCPs expressed overall support for proactive e-consults. Three primary themes emerged: anticipated benefits of proactive e-consults, including educational value and improved specialist access; concerns regarding e-consult implementation, such as potential workload increase and perceptions of documenting inadequate care; and recommendations for leveraging care team members, particularly clinic pharmacists, to implement specialist advice gleaned from e-consults.
This pre-implementation qualitative study highlights PCPs’ recognition of the potential benefits and apprehensions associated with proactive e-consults for DKD care. Strategies identified to facilitate successful integration included engaging support staff to operationalize e-consult recommendations and framing e-consults as part of systemic enhancements rather than critiques of individual care practices.
Source: bmcprimcare.biomedcentral.com/articles/10.1186/s12875-024-02454-w
