Introduction: An eConsult is an asynchronous form of telehealth whereby a primary care provider requests electronic consultation with a specialist to replace a clinic visit. While eConsults have been used successfully in medical specialties, the use of eConsults in urology is relatively uncharacterized.
Methods: Four academic institutions contributed to our study: University of Michigan at Ann Arbor, University of California-San Francisco, University of Washington, and Montefiore Medical Center. We included all urological eConsults performed at each institution from the launch of their program through August 2019. An eConsult was considered “converted” when the reviewing urologist recommended a full evaluation in clinic instead of an electronic response to the clinical question. We report eConsult conversion rate, completion time, response time by physicians, and diagnosis categories.
Results: A total of 462 urological eConsults were reviewed. Of these, 36% (n=166) were converted to a standard consult, with an in-person office visit recommended. Among resolved eConsults with data on provider completion time (n=283), 50.2% were completed in 1-10 minutes, 46.7% in 11-20 minutes, 2.8% in 21-30 minutes, and less than 1% in 31 or more minutes. Among eConsults with time to response from urologist (n= 202), 56.9% of eConsults were responded to in <1 day, 25.2% in 1 day, 6.9% in 2 days, 5.9% in 3 days, and 5% in =4 days. The distribution of eConsult diagnosis categories is summarized in Figure 1.
Conclusions: Our study suggests that eConsults are a feasible alternative to traditional in-person visits in the field of urology for a wide range of common urological diagnoses. Further investigations are needed to understand the impact of eConsults on healthcare costs and access to urological care. Source of
