How eConsults reduce overuse of emergency departments

December 23, 2021

How PCPs reduce overuse of emergency departments

Many issues drive overuse of emergency departments (EDs) by low acuity patients. Diminished access to specialty care, long patient wait times for specialist visits, and poor patient understanding of how to manage chronic conditions are a few examples. eConsults mitigate the disparities in care and access to specialists

In many healthcare systems, hospital closures, practice consolidations, and a lack of access to specialty providers mean that patients must travel far or wait a long time to receive care. This is true for conditions and complaints within a wide range of specialties, and in both rural and urban communities. Without a specialist care plan in place, low acuity patients can end up in overtaxed emergency rooms for conditions that could’ve been managed by primary care doctors much closer to home.

Low acuity patients can quickly obtain access to specialists within the primary care setting. eConsults enable primary care physicians to create and manage expedient care plans while reducing ER visits and improving care delivery.

How eConsults Increase Quality of Care

How eConsults help reduce overuse of emergency departments

eConsults help avoid ER visits and expensive specialty referrals because they allow the PCP to address issues before complications arise. Unlike informal curbside consultations, formal eConsult platforms like AristaMD streamline the physician referral process and improve outcomes for patients.

eConsult technology enables PCPs to obtain a formal consult from a specialist, including the exchange of patient health information (PHI) and a signed summary report provided for the patient record.

While curbside consults involve a casual exchange of information from the PCP to the specialist, eConsults enable PCPs to maintain a formal documentation trail that closely follows a specialist care plan. Specialists are reimbursed for these telehealth consults, PCPs refer fewer patients out to specialists, and patients benefit from the collaboration between their primary care provider and the specialist.

Close monitoring of low acuity patients helps address avoidable complications that are a major driver of unnecessary emergency room visits (more than 70% of them by some counts).

Another bonus of eConsults: they reduce the backlog of specialty appointments (and associated wait times) by enabling PCPs to create an expedient care plan under the guidance of a specialist, but without requiring that the patient schedule a separate specialist consultation.

eConsults enable efficient, convenient care

eConsults empower PCPs to offer a convenient care plan without eliminating specialist input. Specialist-guided care plans often include follow-up PCP visits and testing within the primary care setting. This approach is reimbursable for the specialist, while making ongoing care more accessible and convenient for the patient.

Here’s an example of how an eConsult care plan scenario might work in the real world:

  • A patient visits their PCP with a low acuity complaint that requires specialist oversight (g., rash, back pain, chronic UTIs, high blood sugar, etc.)
  • The PCP reaches out to a specialist through the eConsult platform
  • Within 24 hours, the specialist views the patient’s history, X-rays, labs, and whatever else is typically ordered to evaluate the issue
  • The specialist creates a plan of action that the patient can follow (an in-person exam is always an option but frequently unnecessary)
  • The PCP then works with the patient to implement and coordinate care, treatment, and follow-up
  • The specialist-guided care plan helps the patient avoid serious complications that may require higher level care
  • Expedient care closure is accomplished within the primary care setting

In the above scenario, the patient has access to a specialist visit, but the eConsult is completed in a virtual environment. The patient isn’t required to schedule an appointment or see the specialist. The goal is not only to avoid an ER or emergency clinic visit, which can be costly and unnecessary, but to achieve expedient care closure for the patient.

Mitigating wait times expedites care closure

Telehealth solutions like eConsults allow PCPs to deliver care to patients locally in the primary care setting, yes, but also where it’s most convenient for the patient.

It can take months to realize care closure once a patient is referred outside of a PCP’s office to a specialist. eConsults facilitate timely access to specialist care in a way that’s reimbursable for the specialist, while putting the PCP at the forefront of patient care.

eConsults can positively impact wait times not just for low acuity patients, but for patients with more serious issues that need to be addressed in person by a specialist. By keeping low acuity patients within the purview of the PCP, and thus requiring fewer (or no) specialist appointments, specialists are more readily accessible to the higher acuity patients who need them.

eConsults improve patient outcomes and experience

A 2016 study found that patients waited an average of 24 days for an initial appointment with a new physician. That time frame can skyrocket in busy metropolitan areas like Boston (where the average is 52 days).

In contrast, eConsults can minimize ER visits and reduce specialist wait times by helping PCPs their low acuity patients with specialists within 24 hours.

Telehealth technology including electronic medical records and virtual consultations makes it possible for PCPs and their patients to proactively address chronic and complex health issues in settings that are more convenient and accessible to the patient.

  • An expedient care plan which is overseen by a specialist contributes to better patient outcomes as well as improved patient experience.
  • An expedient care plan requires easy and quick access to a specialist, a safe and secure way to share the patient’s history, tests, and other relevant medical information, and a focus on care closure.

eConsult-facilitated specialist care plans can help reduce ER visits because they directly address issues like the shortage of specialists in the US, increased wait times for patients, and the increased prevalence of no-shows/lack of patient follow up due to inefficient care delivery.

While there is no magic bullet that can solve the overarching issues of inefficiency and lack of access within the US healthcare system, eConsults help mitigate them by enabling access to specialty care from within a primary care setting.