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Implementing eConsults into Health Systems

Kevin Campbell, M.D.
MARCH 25, 2019
Electronic consultations, or eConsults, are growing in popularity and are becoming a very effective way for primary care doctors and specialists to securely communicate with each other in order to discuss complex patient cases. These consults are incredibly efficient and can help patients avoid extra visits to specialists — ultimately freeing up space in crowded health systems, which can reduce patient waiting times and improve patient care.

So, how can we as physicians and healthcare executives leverage eConsults to save time and money for patients and doctors?

Welcome to The Clinical Divide. I’m Dr. Kevin Campbell, a Duke-trained cardiologist and CEO of the health data startup PaceMate. Every week, this Inside Digital Health™ video series examines healthcare technology and medicine’s top news. I bring the views that help physicians and healthcare executives bridge the clinical divide.



eConsults have the potential to be a game changer for both doctors and patients, especially for those on Medicaid or without health insurance. Studies have found that more than 40 percent of referrals to specialists are not even needed. If a patient can get the proper medical advice without having to go and visit a specialist, it could be extremely beneficial — for both patients and physicians. More efficient and appropriate use of specialty consultations will also free up clinic time and allow the patients who truly need specialty consultation to be seen in a much more expedient fashion. 

These eConsults can also be helpful for patients in rural areas who have a lot of trouble traveling long distances to be seen by specialists. By facilitating specialty consultation via digital means, physicians in more remote areas will have the benefit of getting the help that they need to treat complex cases without delay.

The way the eConsults work, if a primary care doctor feels that a specialty consult is necessary for the treatment of a patient, the requesting doctor simply emails a specialist reviewer for help. This email initiates a HIPAA-compliant dialogue — email or video — between the reviewer and doctor and an exchange of clinical information and expertise begins immediately. In many cases, this dialogue may result in the disposition of a particular case without a face-to-face patient specialty consultation. Also, these discussions can better identify those patients who must be seen by a specialist urgently and in person. This type of conversation really facilitates care and allows patients to get the care they need much faster.

This system does not mean that patients do not have access for face-to-face consults with specialists, nor does it mean that specialists are going out of business because they don’t have any consults. In fact, in one health system that has implemented eConsults, waiting times for specialists have fallen by an average of 17 percent and the proportion of appointments scheduled actually rose from 24 percent to 30 percent — everybody wins.

As physicians and healthcare executives, it is really incumbent upon each of us to evaluate new technologies as they emerge, such as eConsults and then implement them into our health systems when and where appropriate. We can no longer simply accept the status quo of a workflow in a healthcare system as, “Oh, that’s the way it has always been done”. Let’s continue to innovate and embrace new ways of doing business. And in the case of eConsults, it appears that they certainly have the potential to save time, cut costs and reduce headaches for both doctors and patients.

Thank you for joining me for this episode of The Clinical Divide. Until next week, I’m Dr. Kevin Campbell, for Inside Digital Health™.

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