Abstract
Purpose :
Despite the known advantages of electronic consultation (eConsult) to patients, providers, and healthcare systems, including increased timely access to specialist consultation, decreased resource waste, and improved care coordination, the role of eConsults in ophthalmology has yet to be explored. We conducted a retrospective chart review to evaluate the feasibility and diagnostic accuracy of a physician-to-physician eConsults ophthalmology program and characterize the types of clinical questions and ophthalmic learning needs of healthcare providers.
Methods :
Ophthalmology eConsults were reviewed to identify submission-to-response time, primary diagnoses made by eConsultants, and referral outcomes including symptom resolution, completion of follow-up appointments, and presentation to an emergency department (ED). eConsults underwent thematic review and categorized based on the type of clinical question asked, urgency, and ophthalmic condition addressed. Demographic data on patients and referring providers were also collected.
Results :
One hundred ophthalmology eConsults were placed, and 100% were responded to by an ophthalmologist. An average of 1.6 days and a standard deviation (SD) of ±1.9 elapsed from the time an eConsult order was placed to the time the consultation was completed. Of the eConsults, 62% (n=62) were recommended for an in-person evaluation; of these, 48.4% (n=30) presented to an ophthalmologist. For patients who had an in-person follow-up, concordance of diagnoses between eConsultant and in-person evaluation was observed in 93% (n=28) of cases. On average, in person evaluations occurred within 28.9 (SD ±27.4) days of the eConsult response. The most common clinical inquiries were related to appropriate triage and referral (24.4%), management (22%), and diagnosis (19.7%). All eConsults were nonurgent. The most common ophthalmic condition addressed was chalazia/hordeola (14%). Only 5% of patients presented to an ED for the same ophthalmic concern addressed by eConsult.
Conclusions :
Ophthalmology eConsultants can diagnose, triage, and manage nonurgent ocular conditions with high accuracy through electronic medical record review. eConsult programs can also facilitate timely access to specialty care.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.