Evaluation and Utility of an Electronic Consultation Program in a Children’s Health System

IF 3 3区医学 Q1 PEDIATRICS

Academic Pediatrics Pub Date : 2025-03-14 DOI:10.1016/j.acap.2025.102815

Dinesh S. Pashankar MD, MBA , Daniel Prior MD , Anita Arora MD, MBA, MHS , Renee Fekieta PhD, MA , Karla Marco MPH, MS , Erica Spatz MD, MHS , Mona Sharifi MD, MPH , Babar Khokhar MD, MBA

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引用次数: 0

Abstract

Objective

Electronic consultations (e-consults) are asynchronous communication between primary care providers (PCPs) and specialists. Studies in adults show that e-consults improve specialty access, but the data in pediatrics are limited. We report the evaluation and utility of a large pediatric e-consult program.

Methods

We reviewed our database for the number of e-consults per specialty, indications, and completion time. We determined the utility of e-consults by assessing health care utilization for the same clinical problem within 2 months following completed e-consults. PCPs and specialists were surveyed to assess time spent on e-consults and satisfaction with the e-consult program.

Results

Thirty-four specialists from 13 specialties completed 2192 e-consults requested by 45 PCPs over 55 months. An average response time for e-consult completion was 0.8 days. Dermatology (42%), endocrinology (16.6%), and neurology (8.2%) were the top 3 specialties with rashes, puberty questions, and seizures as common indications, respectively. Within the 2 months, 85% of patients did not present to the clinics or the emergency room for the same clinical problems addressed in the e-consults. Time spent on the e-consult was less than 20 minutes for PCPs (80%) and specialists (77%). High satisfaction was reported in PCPs (97%) and specialists (85%) with the e-consult program.

Conclusions

In the largest study on pediatric e-consults so far, prompt specialty advice was provided with e-consults to the PCPs by specialists. In most cases, patients did not present to our health system for the same clinical problems within 2 months. Both PCPs and specialists reported high satisfaction with the e-consult program.

查看原文本刊更多论文

儿童健康系统中电子咨询程序的评估与应用。

目的：电子会诊（e-consults）是初级保健医生（PCP）与专科医生之间的异步通信。对成人的研究表明，电子会诊可提高专科就诊率，但儿科方面的数据却很有限。我们报告了一个大型儿科电子会诊项目的评估和效用：我们对数据库中各专科的电子会诊数量、适应症和完成时间进行了审查。我们通过评估完成电子会诊后两个月内相同临床问题的医疗保健使用情况来确定电子会诊的效用。我们还对初级保健医生和专科医生进行了调查，以评估他们在电子会诊上花费的时间以及对电子会诊项目的满意度：来自 13 个专科的 34 名专家在 55 个月内完成了 45 名初级保健医生要求的 2192 次电子会诊。完成电子会诊的平均响应时间为 0.8 天。皮肤科（42%）、内分泌科（16.6%）和神经内科（8.2%）分别是皮疹、青春期问题和癫痫发作适应症最多的三个专科。在两个月内，85% 的患者没有因电子会诊中涉及的相同临床问题到诊所或急诊室就诊。初级保健医生（80%）和专科医生（77%）的电子会诊时间均少于 20 分钟。初级保健医生（97%）和专科医生（85%）对电子会诊项目的满意度很高：在迄今为止最大规模的儿科电子会诊研究中，专家通过电子会诊向初级保健医生提供了及时的专科建议。在大多数情况下，患者在两个月内不会因相同的临床问题到我们的医疗系统就诊。初级保健医生和专科医生都对电子会诊项目表示非常满意。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Academic Pediatrics PEDIATRICS-

CiteScore

4.60

自引率

12.90%

发文量

300

审稿时长

60 days

期刊介绍： Academic Pediatrics, the official journal of the Academic Pediatric Association, is a peer-reviewed publication whose purpose is to strengthen the research and educational base of academic general pediatrics. The journal provides leadership in pediatric education, research, patient care and advocacy. Content areas include pediatric education, emergency medicine, injury, abuse, behavioral pediatrics, holistic medicine, child health services and health policy,and the environment. The journal provides an active forum for the presentation of pediatric educational research in diverse settings, involving medical students, residents, fellows, and practicing professionals. The journal also emphasizes important research relating to the quality of child health care, health care policy, and the organization of child health services. It also includes systematic reviews of primary care interventions and important methodologic papers to aid research in child health and education.