E-CONSULTS: A NOVEL APPROACH TO INCREASE ACCESS TO SUBSPECIALTY CARE IN ENDOCRINOLOGY
AACE ePoster Library. Desai K. 05/13/15; 97773; 709
Dr. Kaniksha Desai
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Abstract
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Mayo Clinic instituted the concept of electronic consults (E-consult) in 2012. E-consults can be ordered by physicians to address targeted clinical questions in both medical and surgical subspecialty fields without the need for the consultant to meet physically with the patient. This study reviews the use of E-consults in the division of endocrinology for the last 3 years.
The Mayo Clinic electronic health record for the Florida campus was queried for all e-consults ordered for the division of endocrinology between January 2012 and December 2014. Orders required a clinical diagnosis subcategory and a clinical question. Categories included thyroid, osteoporosis, calcium/parathyroid, pituitary, lipid, and “other” disorders. Endocrinology consultants reviewed the electronic chart including available notes, labs, imaging, and pathology to answer the clinical question proposed. Recommendations were then placed in the chart <48 hours, including a recommendation for an in person consultation if appropriate. Charts were reviewed for follow up of recommendations as well as occurrence of in person consults. All consultants were surveyed on the average time spent on the E-consult process.
273 E-consults were placed between 2012 and 2014 which resulted in a total of 51 in person consults. The number of E-consults doubled from 2012 to 2014. The majority of E-consults were thyroid (40%) or osteoporosis related (15%) and the lowest number was in lipids. Clinical questions included evaluation/follow up for thyroid nodules, evaluation of hypercalcemia, use of osteoporosis medications and testosterone replacement. Most of the e-consults were ordered by primary care providers (PCP) and consultants on average spent about 30 minutes for each E-consult.
Currently there is a shortage of nearly 1500 adult endocrinologists in the United States to accommodate the demand for services due to the rise of chronic diseases. The current wait time for an endocrinology consultation often ranges from weeks to months. E-consults provide benefits to both the patient and the PCP including faster access to subspecialty care, potential reduction in health care costs, more targeted referrals, and transfer of information. They can be used as a method to help improve subspecialty access in the setting of the shortage of endocrinologists. Given the repetition of some clinical questions, E-consult data can be used to develop educational information for referring providers.
E-consults appear to reduce the need for in person physician consults by >80%, provide benefits to both patients and primary providers and can be used as an approach to help deal with limited access to subspecialists.
The Mayo Clinic electronic health record for the Florida campus was queried for all e-consults ordered for the division of endocrinology between January 2012 and December 2014. Orders required a clinical diagnosis subcategory and a clinical question. Categories included thyroid, osteoporosis, calcium/parathyroid, pituitary, lipid, and “other” disorders. Endocrinology consultants reviewed the electronic chart including available notes, labs, imaging, and pathology to answer the clinical question proposed. Recommendations were then placed in the chart <48 hours, including a recommendation for an in person consultation if appropriate. Charts were reviewed for follow up of recommendations as well as occurrence of in person consults. All consultants were surveyed on the average time spent on the E-consult process.
273 E-consults were placed between 2012 and 2014 which resulted in a total of 51 in person consults. The number of E-consults doubled from 2012 to 2014. The majority of E-consults were thyroid (40%) or osteoporosis related (15%) and the lowest number was in lipids. Clinical questions included evaluation/follow up for thyroid nodules, evaluation of hypercalcemia, use of osteoporosis medications and testosterone replacement. Most of the e-consults were ordered by primary care providers (PCP) and consultants on average spent about 30 minutes for each E-consult.
Currently there is a shortage of nearly 1500 adult endocrinologists in the United States to accommodate the demand for services due to the rise of chronic diseases. The current wait time for an endocrinology consultation often ranges from weeks to months. E-consults provide benefits to both the patient and the PCP including faster access to subspecialty care, potential reduction in health care costs, more targeted referrals, and transfer of information. They can be used as a method to help improve subspecialty access in the setting of the shortage of endocrinologists. Given the repetition of some clinical questions, E-consult data can be used to develop educational information for referring providers.
E-consults appear to reduce the need for in person physician consults by >80%, provide benefits to both patients and primary providers and can be used as an approach to help deal with limited access to subspecialists.
Mayo Clinic instituted the concept of electronic consults (E-consult) in 2012. E-consults can be ordered by physicians to address targeted clinical questions in both medical and surgical subspecialty fields without the need for the consultant to meet physically with the patient. This study reviews the use of E-consults in the division of endocrinology for the last 3 years.
The Mayo Clinic electronic health record for the Florida campus was queried for all e-consults ordered for the division of endocrinology between January 2012 and December 2014. Orders required a clinical diagnosis subcategory and a clinical question. Categories included thyroid, osteoporosis, calcium/parathyroid, pituitary, lipid, and “other” disorders. Endocrinology consultants reviewed the electronic chart including available notes, labs, imaging, and pathology to answer the clinical question proposed. Recommendations were then placed in the chart <48 hours, including a recommendation for an in person consultation if appropriate. Charts were reviewed for follow up of recommendations as well as occurrence of in person consults. All consultants were surveyed on the average time spent on the E-consult process.
273 E-consults were placed between 2012 and 2014 which resulted in a total of 51 in person consults. The number of E-consults doubled from 2012 to 2014. The majority of E-consults were thyroid (40%) or osteoporosis related (15%) and the lowest number was in lipids. Clinical questions included evaluation/follow up for thyroid nodules, evaluation of hypercalcemia, use of osteoporosis medications and testosterone replacement. Most of the e-consults were ordered by primary care providers (PCP) and consultants on average spent about 30 minutes for each E-consult.
Currently there is a shortage of nearly 1500 adult endocrinologists in the United States to accommodate the demand for services due to the rise of chronic diseases. The current wait time for an endocrinology consultation often ranges from weeks to months. E-consults provide benefits to both the patient and the PCP including faster access to subspecialty care, potential reduction in health care costs, more targeted referrals, and transfer of information. They can be used as a method to help improve subspecialty access in the setting of the shortage of endocrinologists. Given the repetition of some clinical questions, E-consult data can be used to develop educational information for referring providers.
E-consults appear to reduce the need for in person physician consults by >80%, provide benefits to both patients and primary providers and can be used as an approach to help deal with limited access to subspecialists.
The Mayo Clinic electronic health record for the Florida campus was queried for all e-consults ordered for the division of endocrinology between January 2012 and December 2014. Orders required a clinical diagnosis subcategory and a clinical question. Categories included thyroid, osteoporosis, calcium/parathyroid, pituitary, lipid, and “other” disorders. Endocrinology consultants reviewed the electronic chart including available notes, labs, imaging, and pathology to answer the clinical question proposed. Recommendations were then placed in the chart <48 hours, including a recommendation for an in person consultation if appropriate. Charts were reviewed for follow up of recommendations as well as occurrence of in person consults. All consultants were surveyed on the average time spent on the E-consult process.
273 E-consults were placed between 2012 and 2014 which resulted in a total of 51 in person consults. The number of E-consults doubled from 2012 to 2014. The majority of E-consults were thyroid (40%) or osteoporosis related (15%) and the lowest number was in lipids. Clinical questions included evaluation/follow up for thyroid nodules, evaluation of hypercalcemia, use of osteoporosis medications and testosterone replacement. Most of the e-consults were ordered by primary care providers (PCP) and consultants on average spent about 30 minutes for each E-consult.
Currently there is a shortage of nearly 1500 adult endocrinologists in the United States to accommodate the demand for services due to the rise of chronic diseases. The current wait time for an endocrinology consultation often ranges from weeks to months. E-consults provide benefits to both the patient and the PCP including faster access to subspecialty care, potential reduction in health care costs, more targeted referrals, and transfer of information. They can be used as a method to help improve subspecialty access in the setting of the shortage of endocrinologists. Given the repetition of some clinical questions, E-consult data can be used to develop educational information for referring providers.
E-consults appear to reduce the need for in person physician consults by >80%, provide benefits to both patients and primary providers and can be used as an approach to help deal with limited access to subspecialists.
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