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The Article in Brief
Patients Assess an eConsult Model's Acceptability at 5 US Academic Medical Centers
Sara L. Ackerman , and colleagues
Background Electronic consultation (eConsult), involving asynchronous primary care clinician-to-specialist consultation, is being adopted at a growing number of health systems. A new study shifts focus from clinician to patient perspectives on the idea of eConsult and patient preferences for involvement in eConsult decision making.
What This Study Found A study across five academic medical centers examined the reaction of patients to the use of electronic consultation for primary care for provider-to-specialist consultation. This focus group study of adult primary care patients was conducted to better understand patients' opinions, as most previous studies focused on clinical and financial impacts and clinician responsibility. Fifty-two participants across five focus groups were introduced to the eConsult model and were asked to discuss potential benefits and drawbacks, as well as acceptability of a hypothetical copay and preferences for involvement in future eConsult decision making and communication. Participants reacted favorably to the eConsult concept; quicker access to specialty care and convenience were cited as key benefits, with approval rates particularly high among those having a trusted primary care clinician. Some patients wanted to be involved in the eConsult decision making and communication. They also expressed a decreased enthusiasm about eConsults if they had a copay. Participants were also concerned about potential misuse of the system and about the exclusion of the patient's illness narrative in the eConsult exchange.
Implications
- The authors argue that the success of eConsult models hinges not only on the engagement and buy-in of primary care clinicians and specialists, but on patient-clinician relationships.
- Furthermore, they recommend that eConsult program implementation projects build in patient outreach strategies and include patients' perspectives in clinician education efforts. The authors note that talking with patients at an early phase of the eConsult implementation process enabled them to share findings with implementation teams as they developed clinician and patient outreach strategies.
- They also recommend that future research assess eConsult experiences and decision-making preferences of more diverse patients, including those with limited digital literacy and without a regular primary care clinician.