World Congress at ACG2017

Simultaneous Plenary Session 4C: IBD

81 - eConsultation to Gastroenterology Specialists: Questions Asked and Cost Saved

Wednesday, October 18
9:50 AM - 10:00 AM
Location: W414 (Level 4)



Category: Practice Management       

Jennifer Wang, MD1, Kimberly Dowdell, MD2, Anne G. Tuskey, MD3, Ann R. Hays, MD2
1University of Virginia, Charlottesville, VA; 2University of Virginia Health System, Charlottesville, VA; 3University of Virginia Digestive Health Center, Charlottesville, VA
Introduction: Electronic consultation (eConsult) is new model being trialed as a means of providing primary care providers (PCP) with direct, efficient, and timely access to specialist expertise in the management of their patients and potentially avoiding the need for face-to-face referrals. We aimed to study the type of questions frequently asked by PCPs and the potential savings associated with eConsult as compared to traditional consults.

Methods: Retrospective study of eConsults to gastroenterology completed at a single U.S. tertiary care academic medical center from January 1, 2015 to May 8, 2017. We reviewed the type of questions asked, gastroenterology content, eConsultation response time, change in referral plans, and indirect cost saving through avoided referrals and travel.

Results: A total of 130 eConsults were reviewed during the study period. The mean response time to eConsult was 54 hours as compared to a greater than 30-day wait time for an initial consultation in the ambulatory digestive health clinic (DHC). The most frequently queried subjects were etiology of chronic diarrhea (14%), colon cancer screening guidelines (12%), chronic abdominal pain (9%), and dysphagia (9%) (Figure1). The most common type of question asked pertained to diagnosis (70%). 68 of 130 eConsults (52%) were resolved without face-to-face consultation with a gastroenterologist. The total mileage saved between patient’s home and the DHC was estimated to be 1,583 miles. Of the 68 avoided referrals, 38 (56%) resulted in successful diagnosis and/or symptom resolution of patients based on the specialist’s recommendations.

Discussion: EConsult appears to be a model that could improve cost effective delivery of timely access to specialist care. It may also improve patient satisfaction by decreasing travel costs and long wait time associated with face-to-face specialist visits. It appears to have the potential to enhance the value in outpatient DHC visits via triage, useful feedback, and pre-visit recommendations. We anticipate demand for eConsult will increase and that national gastroenterology societies should begin to study the financial and medical-legal implications of this health care delivery model.

Supported by Industry Grant: No


Figure 1: common questions asked by eConsults to gastroenterology

Citation: . ECONSULTATION TO GASTROENTEROLOGY SPECIALISTS: QUESTIONS ASKED AND COST SAVED. Program No. 81. World Congress of Gastroenterology at ACG2017 Meeting Abstracts. Orlando, FL: American College of Gastroenterology.

Jennifer Wang

Resident Physician
University of Virginia
Charlottesville, Virginia

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