There are times primary care providers are in need of backup from a specialist for certain patient cases. That could be to seek advice on treatment for illnesses out of their purview, making decisions on whether a patient should be referred to a specialist or identifying the work-up that needs to take place before a patient sees a specialty physician. These consultations typically take place through phone calls, impromptu meetings in public spaces or through a formal referral wait system.
OSF HealthCare is initiating a more efficient way for communication to take place between specialists and primary care clinicians using the electronic medical record (EMR). TeleHealth Services, a part of OSF Innovation, recently implemented e-Consults within the Ministry. The program allows primary care providers to remotely consult a specialist electronically. The request goes to a pool of specialty providers, so the first one available can respond in a timely manner.
The program began with adult cardiology in April 2017 and has since expanded to include pediatric cardiology, adult endocrinology, pediatric surgery, adult neurology, adult and pediatric neurosurgery, adult psychiatry, adult pulmonology and infectious disease. All requests are divided by region, so if a provider in Rockford is seeking assistance, for example, a specialist from the same area will respond.
e-Consults improving patient experience
Standard referrals that took place before e-Consults would typically go through schedulers who would make appointments on a patient’s behalf. However, specialists likely didn’t know the details before receiving a case and had a more difficult time prioritizing which patients needed to be seen first.
The new program puts cases in front of specialists immediately, so they can decide whether a patient should come in as soon as possible. It also allows specialists to offer recommendations for testing that can be done prior to the first visit. That way they have all of the necessary information to make treatment decisions, saving patients an extra visit and getting their needs addressed sooner.
Sometimes, a primary care provider has the expertise and tools to manage a patient but seeks guidance from a specialist before moving forward. This is often the case when clinicians are looking to modify medication prescriptions, a decision that doesn’t require a full specialty visit. The e-consults program is really about optimizing in-person specialty visits and allowing our primary care providers to feel more comfortable handling certain patient conditions.
A year of success
Users of the e-Consults program have grown by 800-percent in a year with the addition of more specialty providers since its launch in April 2017. While specialists have three days to respond to primary provider questions, it’s been found that they typically reply within 24 hours.
Clinicians at our primary care clinics say they receive thorough answers with educational and practical advice from specialists. They also appreciate the ability to better bridge the gap between primary care to specialty care.
We expect the e-Consult program to continue growing in the coming years, making communication between primary care providers and specialists seamless through the health care system.