eConsult Criteria and Referral Order Process
eConsult Criteria for Requesting Specialist Advice
Cindy Craddock, RN
Here’s a sample of eConsults criteria. This is very high level, very black and white; obviously, as you know, there’s a lot more granular that you could read into this. Basically, we have over 70 specialties and sub-specialty areas. The first step is to look at a referral order. If it’s an urgent procedure-related diagnostic, too complex, maybe if it’s a patient that has, you know, stage four renal failure, they see a nephrologist every month. Obviously, those will not be conducive to eConsults. Anything else is the first step “Yes, you can submit an eConsult.”
Now that’s not to say that you’ll never have the patient seen in person, but it’s definitely just kind of a quick triage guide to help you know, what an e-consult can be used for. We’ve seen when we’ve implemented new clinics that are trying to implement the regular referral process, instead of trying to think of “what can be an eConsult,” just look at every referral you’re about to order if you rep to order a referral for your patient. Ask yourself, “is this urgent? Is this a procedure I’m ordering or a diagnostic? Or is this patient already established in this complex?”. If not, then you can think, “I think I maybe can do this as an e-consult.”
Sometimes you don’t know what you would submit if you haven’t seen the results, so that’s just a good way to start.
Five Ways eConsults Support Value-Based Care
Combine your referral management platform with an eConsult solution to reduce patient wait times and the cost of care. Learn five ways our eConsults support value-based care by allowing primary care physicians, nurse practitioners or PAs to submit electronic requests for patient advice to our team of specialists to manage low-acuity patients.
#1 Help Patients Avoid Unnecessary Face-to-Face Specialty Visits
About 70% of eConsults can address what physicians typically send for a face-to-face specialty visit. As a web-based physician-to-physician consultation, there is no need for any particular technology or integration — the PCP orders the referral the same way they would traditionally order one. Or suppose the patient was to go face-to-face for a specialty consult with the provider using our referral nurse coordination, RNN service, and nurse navigators. In that case, our nurse will curate the eConsults by grabbing all of the data needed for the patient from the chart. Private health information is then sent to our specialist, who reviews the data and provides an evidence-based response on that patient’s best practice and management. Within four to six hours, the primary care provider receives a notification and can view the eConsult specialist’s recommendations.
The bottom line — for every specialty visit where we serve the patient using an eConsult and address issues through the primary care provider, we can fend off the need for three face-to-face visits. Also, once you gain specific knowledge from a specialist on a particular condition, you have the answer to the same question when it comes up again.