eConsult for Provider-to-Provider Consultation

The main cost considerations related to electric consultation (eConsult) can be grouped as start-up or infrastructure costs (e.g., equipment, developing electronic forms, creating workflows, and web page design), remunerations, (e.g., for primary care providers, specialist, and auxiliary staff), and societal cost (e.g., productivity loss, time spent travelling, cost of fuel to travel). Considerations for a successful integration of eConsult models into clinical workflows may be broadly categorized into pre-implementation factors (e.g., appropriate training for staff, anticipating and addressing potential barriers or concerns, and having contingency plans for technological failures), implementation factors (e.g., ensuring availability of appropriate data collection and processing devices and software, defining appropriateness of eConsult, building efficiency into the design by using standardized data capture forms, maximizing auto-populating data fields to reduce documentation time, ensuring appropriate confidential documentation, and emphasizing critical information). There were limitations in that no papers were identified to address the questions regarding ethical and professional considerations for the collection, use, and disclosure of protected health information, or the strengths and limitations of a standalone eConsult versus an eConsult platform integrated within an electronic medical records system. Furthermore, although the included studies contained some useful answers, they were not designed to address any of the research questions. Thus, well-designed studies focusing on the individual questions may be necessary for more comprehensive answers.