E-Consultations Improve Access to Care, Reduce Waiting Times

HealthDay News — Electronic consultation (e-consultation), an asynchronous, non-face-to-face consultation between a primary care physician and a specialist, can improve access to care and reduce wait times, according to a study published in the Annals of Family Medicine.

J. Nwando Olayiwola, MD, MPH, from the Center for Excellence in Primary Care at San Francisco General Hospital, and colleagues conducted a randomized trial to examine the efficacy and effectiveness of e-consultations in reducing wait times. Primary care clinicians from 12 practice sites in a community health center were randomized to either a control (traditional referral; 19 clinicians) or intervention (e-consultation referral; 17 clinicians) arm for referral to cardiologists. The clinicians referred 590 patients during the study.

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The researchers found that 69% of e-consultations were resolved without a cardiologist visit. The median days to a review for an e-consultation was 5 days, compared with 24 days for a visit for control patients, after adjustment for covariates. Fewer cardiac-related emergency department visits were observed for the intervention group in a review of 6-month follow-up data.

“E-consultation referrals improved access to and timeliness of care for an underserved population, reduced overall specialty utilization, and streamlined specialty referrals without any increase in adverse cardiovascular outcomes,” the authors wrote. “E-consultations are a potential solution for improving access to specialty care.”


Olayiwola J, Anderson D, Jepeal, N et al. Electronic Consultations to Improve the Primary Care-Specialty Care Interface for Cardiology in the Medically Underserved: A Cluster-Randomized Controlled Trial. Ann Fam Med. 2016;14(2):133-140. doi:10.1370/afm.1869.