Ongoing effects of eConsultation in nephrology on hospital referral rates: An observational study

J Telemed Telecare. 2022 Jul;28(6):423-428. doi: 10.1177/1357633X20942037. Epub 2020 Aug 3.

Abstract

Introduction: eConsultation in nephrology is an innovative way for general practitioners (GPs) to consult a nephrologist. Studies have shown that questions from GPs can be answered and intended referrals can be avoided by eConsultation. However, follow-up data are lacking. The primary aim of this study was therefore to assess whether patients for whom a referral to the outpatient clinic of a medical specialist was avoided in the short term were not then referred for the same problem within one year after the eConsultation.

Methods: All eConsultations sent between June 2017 and April 2018 to seven nephrologists in three different hospitals in The Netherlands were included. Exclusion criteria were duplications and missing data on follow-up. Data were obtained from the eConsultation application forms and from GP medical records.

Results: A total of 173 eConsultations were included. Of the 32 patients for whom a referral was initially prevented, 91% (95% confidence interval 75-98) had not been referred to a specialist for the same problem within one year after the eConsultation.

Discussion: eConsultation in the field of nephrology can prevent referrals in the long term. It can therefore contribute to a more modern and efficient health-care system in which chronic care is provided by GPs in close proximity to patients, while specialist support is easily available and accessible through eConsultation when necessary.

Keywords: access to care; communication; coordination of care; delivery of health care; eConsultation; nephrology; referral to specialist; remote consultation; secondary care; telehealth; telemedicine; transmural care.

Publication types

  • Observational Study

MeSH terms

  • Ambulatory Care Facilities
  • Delivery of Health Care
  • General Practitioners*
  • Humans
  • Nephrology*
  • Referral and Consultation