Background: Electronic physician consultations (e-consults) with endocrinologists represent a safe and effective alternative to many referrals for diabetes care. E-consults represent an important, but underutilized, modality to address the shortage of endocrinologists. Aim: To implement a scalable diabetes e-consult service for a large network of primary care practices in the United States.
Methods: Primary care providers (PCPs) from 40 practices used a designated email to consult endocrinologists based at a diabetes center. Endocrinologists also had remote access to the electronic health records used by consulting PCPs. E-consults provided individualized recommendations for management, evaluation, targeted education or referral to the diabetes center in addition to targeted education. Provider experience surveys were completed online by PCPs and specialists after each consult.
Results: Between Feb-Sep 2022, 55 e-consults were completed; 86% within 2 business days. The service was positively reviewed by PCPs; 96% reported the e-consult was helpful, 86% reporting more confidence in diabetes care; and 64% reported the e-consult saved them time. A majority of e-consults (PCP, 79%; endocrinologist, 77%) required <10 mins to complete. Specialists made no recommendations for a patient referral to the diabetes center.
Conclusions: A diabetes e-consult service can be rapidly implemented with minimal administrative support. It has the potential to bring greater diabetes expertise to primary care practices and save the PCPs time while avoiding unnecessary referrals to endocrinology practices. Future analyses will address the clinical impact of the e-consult service.
J.Mitri: Other Relationship; Novo Nordisk, Research Support; Kowa Company, Ltd. N.Cibotti granof: None. S.Herzlinger botein: None. S.N.Mehta: None.