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Online Consult Program Cuts Wait Times for Specialists

News  |  By Doug Desjardins  
   March 20, 2017

Los Angeles County primary care physicians use the pilot program to consult with medical specialists online before making a patient referral.

This story originally appeared in California Healthfax.

A pilot program that helps primary care physicians in Los Angeles County refer patients to specialists has reduced wait times by more than 17% in its first three years of operation.

The eConsult program allows primary care physicians to consult with medical specialists online before making a patient referral, a consult that helps physicians determine whether a referral is necessary.

A Health Affairs study of the program that appeared in the March issue of found that 25% of patients whose cases went through the eConsult network had their health issues resolved without having to see a specialist and that the average wait time to see a specialist declined 17.4% from 2012 to 2015.

"It's a simple program that's had a huge impact on primary care and referral times in Los Angeles County," said Mario Gutierrez, executive director for the Center for Connected Health Policy, a Sacramento-based organization that promotes telemedicine.

"We think it can be a model for other states to use." The study found that the number of consults performed under the program grew from 86 per month during the third quarter of 2012 to 12,082 per month during the third quarter of 2015.

By the end of 2015, 3,060 primary care providers and 479 medical specialists in Los Angeles County were using the program in 86 specialty services.

Lower Average Wait Times
In addition to reducing the average wait time to see a specialist by 17.4%—from 63 days to 52 days—the program increased the percentage of appointments scheduled within 30 days from 24% to 30.2%.

The decrease in the average wait time varied by specialty, ranging from a 15% decrease for podiatrists to a 39% decrease for ear, nose, and throat specialists.

The study noted that before the program launched, some patients had to wait up to nine months for an appointment with a specialist.

In addition, some physicians were frustrated to the point where they "referred their patients to the emergency department in an attempt to expedite a specialist consultation," the report stated.

The study suggested that the eConsult program offered "continuing education" as primary care physicians learned through their interactions with specialists.

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"Over time, there could be less of a need for primary care providers to send eConsult requests for easily manageable issues. Consistent with this, we observed a decrease in eConsult requests resolved without a visit during the study period."

The eConsult program has continued to expand since the end of the study period in December 2015, said Paul Giboney, director of specialty care for the Los Angeles County Department of Health Services.

"Since the end of 2015, we have expanded eConsult to use by providers in county jails, the LA County Department of Public Health, and the LA County Department of Mental Health Services," Giboney said.

"There are now more than 4,000 providers submitting over 17,000 eConsults per month."

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