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Electronic consultations (e-consults) to improve access to specialty care: a systematic review and narrative synthesis.

Vimalananda VG, Gupte G, Seraj SM, Orlander J, Berlowitz D, Fincke BG, Simon SR - J Telemed Telecare (2015)

Bottom Line: Our goal was to systematically review and summarize the literature describing the use and effects of e-consults.E-consults are feasible in a variety of settings, flexible in their application, and facilitate timely specialty advice.More extensive and rigorous studies are needed to inform the e-consult process and describe its effect on access to specialty visits, cost and clinical outcomes.

View Article: PubMed Central - PubMed

Affiliation: Center for Healthcare Organization and Implementation Research (CHOIR), US Department of Veterans Affairs, Bedford, Massachusetts, USA Section of Endocrinology, Diabetes, and Nutrition, Boston University School of Medicine, Boston, Massachusetts, USA varsha.vimalananda@va.gov.

No MeSH data available.


Basic steps of an e-consultation (e-consult).The flow diagram indicates the steps involved in a typical e-consult, though not all the steps occur for every e-consult in every system. PCPs and other types of requesting providers may judge it necessary to discuss the decision to place an e-consult with the patient. They request the e-consult within the EHR or secure Web-based portal. The request may be templated, rely on free text entry of relevant data, or both. The specialist receives and reviews the e-consult, referring if appropriate and feasible to the EHR for supporting information. The specialist has the option to arrange for or suggest a face-to-face specialty clinic visit, complete and deliver the e-consult electronically, or request additional information which would inform either decision. Additional information may include details of the history, exam, or test results, but may also include recommendations for work-up and testing that can be completed prior to a face-to-face consultative visit.
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fig2-1357633X15582108: Basic steps of an e-consultation (e-consult).The flow diagram indicates the steps involved in a typical e-consult, though not all the steps occur for every e-consult in every system. PCPs and other types of requesting providers may judge it necessary to discuss the decision to place an e-consult with the patient. They request the e-consult within the EHR or secure Web-based portal. The request may be templated, rely on free text entry of relevant data, or both. The specialist receives and reviews the e-consult, referring if appropriate and feasible to the EHR for supporting information. The specialist has the option to arrange for or suggest a face-to-face specialty clinic visit, complete and deliver the e-consult electronically, or request additional information which would inform either decision. Additional information may include details of the history, exam, or test results, but may also include recommendations for work-up and testing that can be completed prior to a face-to-face consultative visit.

Mentions: The basic steps to an e-consult are illustrated in Figure 2, but e-consult implementation and management across systems vary widely as they are shaped by both the existing information technology (IT) infrastructure and workflow processes as defined within each institution or clinical department. To illustrate the range of possibilities, we describe the e-consult program at the three exemplar sites contributing most to the literature.Figure 2.


Electronic consultations (e-consults) to improve access to specialty care: a systematic review and narrative synthesis.

Vimalananda VG, Gupte G, Seraj SM, Orlander J, Berlowitz D, Fincke BG, Simon SR - J Telemed Telecare (2015)

Basic steps of an e-consultation (e-consult).The flow diagram indicates the steps involved in a typical e-consult, though not all the steps occur for every e-consult in every system. PCPs and other types of requesting providers may judge it necessary to discuss the decision to place an e-consult with the patient. They request the e-consult within the EHR or secure Web-based portal. The request may be templated, rely on free text entry of relevant data, or both. The specialist receives and reviews the e-consult, referring if appropriate and feasible to the EHR for supporting information. The specialist has the option to arrange for or suggest a face-to-face specialty clinic visit, complete and deliver the e-consult electronically, or request additional information which would inform either decision. Additional information may include details of the history, exam, or test results, but may also include recommendations for work-up and testing that can be completed prior to a face-to-face consultative visit.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2 - License 3
Show All Figures
getmorefigures.php?uid=PMC4561452&req=5

fig2-1357633X15582108: Basic steps of an e-consultation (e-consult).The flow diagram indicates the steps involved in a typical e-consult, though not all the steps occur for every e-consult in every system. PCPs and other types of requesting providers may judge it necessary to discuss the decision to place an e-consult with the patient. They request the e-consult within the EHR or secure Web-based portal. The request may be templated, rely on free text entry of relevant data, or both. The specialist receives and reviews the e-consult, referring if appropriate and feasible to the EHR for supporting information. The specialist has the option to arrange for or suggest a face-to-face specialty clinic visit, complete and deliver the e-consult electronically, or request additional information which would inform either decision. Additional information may include details of the history, exam, or test results, but may also include recommendations for work-up and testing that can be completed prior to a face-to-face consultative visit.
Mentions: The basic steps to an e-consult are illustrated in Figure 2, but e-consult implementation and management across systems vary widely as they are shaped by both the existing information technology (IT) infrastructure and workflow processes as defined within each institution or clinical department. To illustrate the range of possibilities, we describe the e-consult program at the three exemplar sites contributing most to the literature.Figure 2.

Bottom Line: Our goal was to systematically review and summarize the literature describing the use and effects of e-consults.E-consults are feasible in a variety of settings, flexible in their application, and facilitate timely specialty advice.More extensive and rigorous studies are needed to inform the e-consult process and describe its effect on access to specialty visits, cost and clinical outcomes.

View Article: PubMed Central - PubMed

Affiliation: Center for Healthcare Organization and Implementation Research (CHOIR), US Department of Veterans Affairs, Bedford, Massachusetts, USA Section of Endocrinology, Diabetes, and Nutrition, Boston University School of Medicine, Boston, Massachusetts, USA varsha.vimalananda@va.gov.

No MeSH data available.