Evaluation of E-Consults in Healthcare Delivery

Abstract

E-onsults offer a digital platform where primary care providers (PCP) can consult the specialists and obtain feedback or offer a direct specialty referral to the patients. In this work, we aim to investigate whether e-consults can help match patients to the right care provider (PCP or Specialist) and reduce delays. We offer a high-level abstraction of e-consult operations using an analytical framework that quantifies the benefit of e-consults in the context of efficient matching in a flexible service system. With heterogeneous patients who lack information regarding the severity of their condition, a Bayesian framework is developed to estimate the true severity, parametrized by the level of e-consult efficacy, a measure of the degree of PCPs and specialists’ communication and information sharing efforts. Patients react to e-consults based on their perceived utility which is sensitive to delay and mismatch costs. Under incentive compatibility assumptions, equilibrium patient flows given perfect and imperfect e-consults are identified. Fundamental properties of the flexible service system and the value of e-consults are investigated. We conclude analytically that, e-consults, when implemented with increasing perfection, enhance the operational and economic performance of the care delivery system. When designed appropriately, e-consults offer the promise to improve patient access to care with streamlined patient flow, improved care quality, and reduced costs and redundancies.