e-Consults is a program that Parkland started piloting in 2018 using email consultations as a promising solution to provide more care using fewer resources.
The program as piloted in Parkland’s Gastroenterology (GI) Clinic. The clinic receives more than 400 referrals every month from physicians at Parkland’s community-based health centers. At one time, the wait list had reached more than six months long.
As a way to meet that demand and care for patients in a more timely manner, the e-Consult pilot was developed.
The program eliminates unnecessary clinic appointments to ensure patients seen in clinic are those who will most benefit from face-to-face visits.
The e-Consult service involves a secure, private email from the primary care provider to the specialist who has access to the entire electronic health record, allowing the primary care physician to get a quick consult with a specialist via secure email about a question or concern rather than requiring the patient to have a face-to-face visit with the specialist every time.
The GI team identified broad categories of patients whose reason for referral could be answered satisfactorily by an e-Consult. The GI team collaborated with Parkland’s IT experts to build a new user-friendly e-Consult platform into the existing Parkland electronic health record that required no additional training for physicians. This is the process now used when developing new e-Consults for specialty service lines.
Initially available at three pilot clinics, it has since expanded into several outpatient clinics. The proportion of e-Consult to in-person consults grew to 45 percent within six months. Guaranteeing a turnaround-time of three business days for e-Consults, the GI specialists were able to reduce the wait list for in-clinic consultations, expediting treatment for patients most in need of one-on-one specialty care.
In fact, two-thirds of all e-Consult cases required less than 15 minutes for electronic consultation, enabling Parkland experts to provide faster answers for patients about their care, free up clinic slots for patients needing in-person visits and improve provider satisfaction.