e-Consults in gastroenterology: An opportunity for innovative care.


Journal Article

BACKGROUND AND AIM: Deploy and evaluate a gastroenterology (GI) electronic consultation (e-consult) program. E-consults are a promising approach to enhance provider communication, facilitate timely specialty advice and may replace some outpatient visits. STUDY: As part of our health system's efforts to provide more cost-effective care under risk-based contracts, we implemented an e-consult program where referring providers submit patient-specific clinical questions electronically via an electronic referral system. A GI consultant then reviews the patient's record and provides a written recommendation back to the referring physician. For our program evaluation, we conducted chart reviews of each e-consult to understand how the program was being used and surveyed the participating providers and consultants. RESULTS: From September 2015 to March 2016, we received 144 e-consults, with most questions concerning GI symptoms or abnormal hepatology labs. Only 36% of e-consults recommended an in-person GI consult or procedure. In our survey of participating providers, referring providers strongly agreed that the GI e-consults promoted good patient care (88%) and were satisfied with the program (84%). The majority of GI consultants felt strongly that e-consults were useful for referring providers and their patients, but that current reimbursement and time allotted were not adequate. CONCLUSIONS: We report on the implementation of a GI e-consult program within an ACO, showing that many clinical questions could be answered using this mechanism. E-consults in gastroenterology have the potential to reduce unnecessary visits and/or procedures for patients who can be managed by their primary provider, potentially increasing access for other patients.

Full Text

Duke Authors

Cited Authors

  • Venkatesh, RD; Campbell, EJ; Thiim, M; Rao, SK; Ferris, TG; Wasfy, JH; Richter, JM

Published Date

  • September 2019

Published In

Volume / Issue

  • 25 / 8

Start / End Page

  • 499 - 505

PubMed ID

  • 29973131

Pubmed Central ID

  • 29973131

Electronic International Standard Serial Number (EISSN)

  • 1758-1109

Digital Object Identifier (DOI)

  • 10.1177/1357633X18781189


  • eng

Conference Location

  • England