Recommendations of specialists were highly adhered to by primary care clinicians when advice was provided through electronic consultation services, according to a study published in Annals of Family Medicine.
Researchers retrospectively analyzed the Champlain Building Access to Specialists through eConsultation service for data relating to primary care clinicians’ adherence to recommendations made by specialists and how quickly these recommendations were communicated to the patients. Patients’ demographic and clinical information, specialists’ records and recommendations, and primary care clinicians’ actions and questions were collected from the database between January 20, 2017, and August 31, 2017.
The most common requests for the 291 electronic consultations were for dermatology specialists (32%), orthopedic specialists (8%), and neurology specialists (7%). The specialist median response time was 3 days, and the most common question asked by primary care clinicians was related to diagnoses (63%).
The specialists’ recommendations were followed by primary care clinicians 82% of the time, with the most common recommendation being initiating a new drug treatment (21%). The electronic consultation was communicated to the patients 79% of the time, occurring after a median time of 5 days, and most frequently occurring face-to-face (38%). Bonferroni-corrected χ2 tests indicated a significant difference between primary care clinicians adherence to specialist recommendations for dermatology cases (80%) vs nondermatology cases (83%).
Limitations of this study include the retrospective nature of this study and the study population coming from a single health center.
Researchers concluded that “the [electronic consultation] service delivers specialist advice that is actionable by primary care clinicians and communicated in a timely fashion to patients,” and further research is warranted to study the use of electronic consultation in a diverse group of primary practice settings.
de Man G, Moroz I, Mercer J, Keely E, Liddy C. Primary care clinician adherence to specialist advice in electronic consultation. Ann Fam Med. 2019;17(2):150-157.