RT Journal Article
SR Electronic
T1 Patients Assess an eConsult Model’s Acceptability at 5 US Academic Medical Centers
JF The Annals of Family Medicine
JO Ann Fam Med
FD American Academy of Family Physicians
SP 35
OP 41
DO 10.1370/afm.2487
VO 18
IS 1
A1 Sara L. Ackerman
A1 Kim Dowdell
A1 Karl T. Clebak
A1 Meagban Quinn
A1 Scott A. Shipman
YR 2020
UL http://www.annfammed.org/content/18/1/35.abstract
AB PURPOSE Electronic consultation (eConsult), involving asynchronous primary care clinician-to-specialist consultation, is being adopted at a growing number of health systems. Most evaluations of eConsult programs have assessed clinical and financial impacts and clinician acceptability. Less attention has been focused on patients’ opinions. We set out to understand patient perspectives and preferences for hypothetical eConsult use at 5 US academic medical centers in the process of adopting an eConsult model.METHODS We invited adult primary care patients to participate in focus groups. Participants were introduced to the eConsult model, considered its potential benefits and drawbacks, judged the acceptability of a hypothetical copay, and expressed their preferences for future involvement in eConsult decision making and communication. Thematic analysis was used for data interpretation.RESULTS One focus group was conducted at each of the 5 sites with a total of 52 participants. Focus groups responded positively to the idea of eConsult, with quicker access to specialty care and convenience identified as key benefits. Approval was particularly high among those with a trusted primary care clinician. Preference for involvement in eConsult decision making and communication varied and enthusiasm about eConsult waned when a hypothetical copay was introduced. Concerns included potential misuse of eConsult and exclusion of the patient’s illness narrative in the eConsult exchange.CONCLUSIONS Primary care patients expressed strong support for eConsult, particularly when used by a trusted primary care clinician, in addition to voicing several concerns. Patient involvement in eConsult outreach and education efforts could help to enhance the model’s effectiveness and acceptability.