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. 2021 May;8(3):321-327.
doi: 10.1097/UPJ.0000000000000209. Epub 2020 Dec 2.

Interprofessional Consultations (eConsults) in Urology

Milan Patel  1   2 , Adam J Gadzinski  3 , Alexander M Bell  4 , Kara Watts  5 , Emma Steppe  1 , Anobel Y Odisho  4   6 , Claire C Yang  3 , Chad Ellimoottil  1   2
Affiliations

Interprofessional Consultations (eConsults) in Urology

Milan Patel et al. Urol Pract. 2021 May.

Abstract

Introduction: An interprofessional consultation (eConsult) is an asynchronous form of telehealth whereby a primary care provider requests electronic consultation with a specialist in place of an in-person consultation. While eConsults have been successfully implemented in many medical specialties, their use in the practice of urology is relatively unknown.

Methods: We included data from four academic institutions: University of Michigan, University of California -San Francisco, University of Washington, and Montefiore Medical Center. We included every urological eConsult performed at each institution from the launch of their respective programs through August 2019. We considered an eConsult "converted" when the participating urologist recommended a full in-person evaluation. We report eConsult conversion rate, response time, completion time, and diagnosis categories.

Results: A total of 462 urological eConsults were requested. Of these, 36% were converted to a traditional in-person visit. Among resolved eConsults, with data on provider response time available (n=119),53.8% of eConsults were addressed in less than 1 day; 28.6% in 1 day; 8.4% in 2 days; 3.4% in 3 days; 3.4% in 4 days; 1.7% in 5 days; and 0.8% in ≥6 days. Among resolved eConsults, with data on provider completion time available (n=283), 50.2% were completed in 1-10 minutes; 46.7% in 11-20 minutes; 2.8% in 21-30 minutes; and less than 1% in ≥31 minutes.

Discussion: Our study suggests that eConsults are an effective avenue for urologists to provide recommendations for many common non-surgical urological conditions and thus avoid a traditional in-person for low-complexity situations. Further investigation into the impact of eConsults on healthcare costs and access to urological care are necessary.

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Conflict of interest statement

DECLARATION OF CONFLICTING INTERESTS: The Authors declare that there is no conflict of interest.

Figures

Figure 1:
Figure 1:
Distribution of eConsult diagnosis. Data shown for all econsults, then stratified by those that were resolved or converted to in-person consultation. *eConsults from one institution (N = 46) did not have conversion/resolution rate data and were excluded.
Figure 2:
Figure 2:
Frequency of converted and resolved eConsults by institution. Resolved visit counts further divided by provider completion time. *Provider completion time data was not available for resolved visits (n=13) from Institution D.
See this image and copyright information in PMC

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