Study Examines Use of Electronic Consults for Allergy/Immunology

Implementation of an electronic consult (e-consult) program at an academic allergy/immunology practice showed increasing use of e-consults for new consults, according to a study published online in the Journal of Allergy and Clinical Immunology: In Practice.

Neelam A. Phadke, M.D., from Massachusetts General Hospital in Boston, and colleagues reviewed e-consults at an academic allergy/immunology practice (Aug. 10, 2016, through July 31, 2018) to determine consult volume, outcomes, indications, and timing. Referral reasons and wait times were compared to those of in-person visits.

The researchers found that e-consults grew from 1 to 10 percent of all new consults, with simultaneous growth seen for in-person consults, too. Based on 306 completed e-consults, 13.4 percent made diagnostic, therapeutic, or alternative referral recommendations, with nearly three-quarters of recommendations (73 percent) followed. Nearly 60 percent of e-consult patients required an in-person allergy/immunology consult, and few e-consult patients (<2 percent) saw an allergist without an e-consult recommendation to do so. Compared with in-person consults, e-consults were used more often for adverse drug reactions (9 versus 66 percent), especially penicillin allergy (61 percent of all e-consults), and immunodeficiency (2 versus 15 percent). E-consults took a median of 11 minutes, with a median turn-around time of 22 hours. Implementation of e-consults was associated with a decreased median in-person consult wait time (1.5 calendar days).

"Implementation of an e-consult program resulted in decreased in-person wait times despite an increase in overall consult volume, supporting this model's ability to provide expedited, problem-focused care," the authors write.

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