Are You Using eConsults to Develop Interim Care Plans?
In this video, Maggie Lewis, a Nurse Practitioner, discusses how she uses eConsults to develop interim care plans for patients.
Maggie Lewis, NP & eConsult User
Are you using eConsults to develop interim care plans? So the patient does need to go forward. Um, you know, Dr. Coggshall had mentioned like a case where maybe you’re doing a skin assessment and there are multiple lesions, or there are things that are going on and you do need to have them go to a specialist, but it’s gonna be a six-month wait. So what can we do in the interim? Are you doing those types of things? And, um, are you seeing like on, on the flip side that e-consult, um, maybe do help to expedite face-to-face after they’ve had the e-consult, because now the specialist is very aware that someone has weighed in and, um, just I’m curious how that’s working in your practice.
I have been able to utilize it in both respects. We have taken where we have a patient who’s waiting to see if something will come back abnormal on a test. For example, even the hepatology testing or the hepatologist, we had a patient who had some abnormal lab work. We knew he needed to get in to see the hepatologist, but the wait was a little bit. We sent a consult over, and the hepatologist came back and said, “In the meantime order this imaging, these extra lab tests.” Then really by the time the patient went to see the specialist, everything was already ordered and done. So they needed to kind of take the lab work and the, and the imaging results and kind of figure out the treatment plan from there. However, we were able to save time because it was already done for the patient in the meantime while they were waiting.
“That’s a good point. And you, are you seeing this too with like chronic care conditions and complex conditions?”
Yes. I mean, even to, you know, to get to neurology or those kinds of things is hard. But if we can get some advice on and even sometimes it’s just for us to know what kind of test we should order next that would be helpful to know. Maybe not necessarily for my treatment plan, but when we can get this patient to the specialist what would they ask for so that we already have that imaging done or those tests run so that they don’t have to waste their time either? It’s greatly helpful I think on both ends of treating the patient. Sometimes these tests will come back negative and they say “Okay, this patient does not need to go see the neurologist that I thought they needed to go see because all of these tests are negative and they don’t have what we thought we were gonna rule out anyway”. So then we kind of go down a different route and try to figure out what is going on, but we’ve saved time for that, for that patient in an unnecessary consult. And then, you know, and sometimes it’s just getting things together while they’re waiting for that specialist.
Evaluate Practice Performance Metrics for eConsult Programs
Practice performance metrics are in focus whenever a new tool is introduced to improve patient care. In this series, we’ll focus on practice success and patient care when adopting or maintaining an eConsult program. Many of these strategies apply to increasing the adoption of any new technology or program.
There are a few common challenges to effective care and practice success:
- Primary care providers lack the tools and time to help patients navigate care. The average PCP sees between 10-20 patients per day. Patient care is their goal. Adding new technology adds to their workload.
- At the same time, not getting specialist advice for the patient is creating additional work for PCPs. More than 40% of referrals never get scheduled. That means more work for the PCP as patients boomerang back to the primary care setting with the same untreated condition.
- 25% of our healthcare costs are for unnecessary tests and treatments.