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


ABSTRACT:

Background

We define electronic consultations ("e-consults") as asynchronous, consultative, provider-to-provider communications within a shared electronic health record (EHR) or web-based platform. E-consults are intended to improve access to specialty expertise for patients and providers without the need for a face-to-face visit. Our goal was to systematically review and summarize the literature describing the use and effects of e-consults.

Methods

We searched PubMed, EMBASE, the Cochrane Library, and CINAHL for studies related to e-consults published between 1990 through December 2014. Three reviewers identified empirical studies and system descriptions, including articles on systems that used a shared EHR or web-based platform, connected providers in the same health system, were used for two-way provider communication, and were text-based.

Results

Our final review included 27 articles. Twenty-two were research studies and five were system descriptions. Eighteen originated from one of three sites with well-developed e-consult programs. Most studies reported on workflow impact, timeliness of specialty input, and/or provider perceptions of e-consults. E-consultations are used in a variety of ways within and across medical centers. They provide timely access to specialty care and are well-received by primary care providers.

Discussion

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.

SUBMITTER: Vimalananda VG 

PROVIDER: S-EPMC4561452 | biostudies-literature | 2015 Sep

REPOSITORIES: biostudies-literature

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

Vimalananda Varsha G VG   Gupte Gouri G   Seraj Siamak M SM   Orlander Jay J   Berlowitz Dan D   Fincke Benjamin G BG   Simon Steven R SR  

Journal of telemedicine and telecare 20150520 6


<h4>Background</h4>We define electronic consultations ("e-consults") as asynchronous, consultative, provider-to-provider communications within a shared electronic health record (EHR) or web-based platform. E-consults are intended to improve access to specialty expertise for patients and providers without the need for a face-to-face visit. Our goal was to systematically review and summarize the literature describing the use and effects of e-consults.<h4>Methods</h4>We searched PubMed, EMBASE, the  ...[more]

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