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A study of 6,000 electronic specialty consultations for person-centered care at The Mayo Clinic

Gerald D. Malagrino, Rajeev Chaudhry, Matthew Gardner, Michael Kahn, Lloyd Speer, Barbara R. Spurrier, Nicholas F. LaRusso

Abstract


Rationale, aims, and objective: To study the utility and outcome of electronic specialty consultations between primary care physicians and specialists at a large, multispecialty academic practice and to determine best practices for this model.

Method: Use of a common electronic health platform for the provision of ordering specialty care.  A new model was put in place in which an electronic consultation with a specialist could substitute for a face-to-face consultation for certain defined conditions.  The financial model for this type of consultation was set up at the Mayo Clinic.  All electronic consultations from January 2009 to September 2011 at the Mayo Clinic Rochester were evaluated for appropriate condition ordered, clarity of question, time to completion and time saved for the specialty practices.

Results: Thirty-nine specialties participated in this new model of care to define 158 conditions; 6,253 electronic consults were performed with a greater than 98% quality rate for appropriate condition ordered and clarity of question, with 93% completed within 2 business days.  These consultations, termed eConsults, were accomplished in roughly one-half to one-third of the time of a face-to-face consultation, saving time for the specialist.

Conclusions: The electronic consult is a new modality for a primary care physician to solicit specialists' input. While this model is not appropriate for every circumstance, it can provide significant value beyond that of a traditional face-to-face consultation.


Keywords


Delivery of health care, electronic consults, health care innovation, person-centered medicine, referral and consultation, remote consultation, specialty care

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References


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DOI: http://dx.doi.org/10.5750%2Fijpcm.v2i3.266

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