E-Consults: Providing convenient specialty advice

December 2, 2019  //  FOUND IN: Updates & Resources

A patient is relaxing at home on a crisp, fall weekend, ready to watch her team dominate on the gridiron (U-M, of course!). She settles into the couch and grabs the TV remote, but notices an odd, dime-sized red patch on her arm. She wonders what it might be, but shrugs it off. To her dismay, the patch gets bigger and bigger over the next few days and begins to itch. It’s time to have it looked at by her primary care provider (PCP).

During the visit, the provider is fairly certain the spot is atopic dermatitis, but sees an irregularity and wants a second opinion. The patient isn’t looking forward to another doctor’s appointment, and is thrilled when her provider suggests an E-Consult with a Michigan Medicine allergy specialist. She’s not quite sure what an E-Consult is, but if it saves her the time and hassle of a specialist appointment, she’s all in!

So what exactly is an E-Consult?

Convenient, provider-to-provider specialty advice

An E-Consult is a PCP’s request for specialty medical advice initiated through MiChart. In this case, the patient’s PCP wants advice on that itchy red spot on her arm. The patient’s PCP messages a Michigan Medicine allergy specialist and provides specific details. The PCP then receives a response through the MiChart in-basket within 72 business hours.

More than 7,000 E-Consults have transpired since the program’s inception in August 2016, with approximately 85 percent of them saving a potential trip to a specialty clinic. If an office visit is still required after an E-Consult, it acts as a referral and a specialist appointment scheduled.  

What specialties currently utilize E-Consults?

E-Consults are best used for easily managed issues, and are available to Michigan Medicine and University Health Service PCPs. These providers can submit an E-Consult for a number of specialties, including:

  • Allergy (adult and pediatric)
  • Cardiology
  • Dermatology (adult and pediatric)
  • Gastrointestinal
  • Hematology
  • Hepatology
  • ID
  • Metabolism, endocrinology and diabetes
  • Nephrology
  • Neurology (adult and pediatric)
  • Otolaryngology (adult and pediatric)
  • Pulmonary
  • PM&R
  • Reproductive endocrinology and infertility
  • Rheumatology
  • Sleep Medicine
  • Urology (adult and pediatric)

E-Consults benefit both patients and providers. In the scenario above, the E-Consult was a time saver – the patient didn’t need to commute to a clinic and be seen by a specialty provider. For the PCP, E-Consults allowed for a continuum of care with their patient along with the ability to receive timely, well-documented advice on how to manage the issue. Also benefitting are the specialists, who are better able to document traditional curbside consults while opening up specialty clinic access.

A strategic endeavor

In a time where Michigan Medicine’s strategic focus is on improving access, patient satisfaction and the overall level of care we provide to our patients, E-Consults are an important tool. They raise the efficiency of the care delivered and are another innovation in the organization’s Virtual Care toolbox that helps deliver care in non-traditional ways. Best of all, the patient noted earlier in this story was treated with the help of her PCP and an allergist in only one appointment.

Over the next year, E-Consults will continue to expand to more service lines and will eventually be available for external referring providers as well as PCPs. That means more satisfied patients and less clinic visits, creating better access for all.

Make sure to check out the Dec. 16 issue of Michigan Medicine Headlines, when the Virtual Care series will highlight Telespecialty consults.