'Electronic Consultations' signify usefulness during COVID-19 Pandemic

As the COVID-19 virus wreaks havoc with the healthcare system, 'Electronic consultations method or 'e-consults' is stepping up into the spotlight and helping healthcare provider organizations and caregivers better respond to the needs of the people.

Hyderabad:SARS-CoV2, the virus which is responsible for the COVID-19 pandemic, has forced rapid changes in healthcare delivery. To combat the virus, in such a gloomy situation, new research from Massachusetts General Hospital has signified the usefulness of electronic consultations method, or e-consults.

According to reports, Electronic consultations (e-consults), in particular, maybe an effective method of sustaining speciality consultative care while preserving social distancing and reducing demands for personal protective equipment.

Dr Neelam A. Phadke, MD, Dr Jason Wasfy, MD, and their colleagues examined daily consultation requests from February 1, 2020, through April 1, 2020, at Mass General Hospital. Such technology allows clinicians to ask specific questions of specialists, who then provide recommendations after reviewing a patient’s electronic health record with no direct specialist-to-patient contact involved, reports said.

"We have already seen patients of all ages defer routine or life-saving care including everything from pediatric vaccinations for highly preventable diseases to evaluation for potentially fatal conditions such as strokes and heart attacks,” said Dr Phadke, an Immunologist at Mass General and a Health Policy & Administration fellow at the Mass General Physicians Organization.

"As experts predict that our nation may see effects of this pandemic span the next 18 to 24 months, it is clear that our health care system must step up and find alternative care delivery methods so that patients feel comfortable seeking much-needed care. E-consults fulfil this demand as there is no direct patient-to-specialist contact that would require a patient to come into the hospital or clinic," Dr Phadke said.

Using the e-Consultation platform, patients will be able to make appointments and get advice from leading medical specialists at any time, via a private messaging or video conference service at any time of the year. E-Consultation is fully encrypted and GDPR-compliant. Doctors can guarantee their patients’ data will remain secure from fraudsters and cybercriminals, unlike mainstream chat platforms, reports added.

It is pertinent to be mentioned here that the telemedicine, e-consults have been used at Mass General Hospital since 2014 as a tool to improve population health—reduce unnecessary patient visits to specialists and decrease wait times for those patients who need in-person specialist visits.

"By making use of an already-existing electronic health record system, e-consults add minimal cost to the health care system during a time when all sectors of the economy are struggling financially," Dr Phadke added.

Dr Phadke noted that although e-consults cannot replace in-person visits for acute conditions (such as heart attacks) or those requiring procedures (such as vaccinations), they allow many patients to receive care that they may have otherwise skipped or neglected.

"The use of e-consults to provide care during the pandemic shows how tools developed in other settings can be deployed during an emergency. In 2014, e-consults were created as a tool for reducing costs and improving value. We developed these tools as a response to accountable care organizations, which are contracts that reward health care providers for reducing preventable health costs," said, Dr Wasfy, Director of Quality and Analytics at Mass General's Corrigan Minehan Heart Center and Medical Director of the Mass General Physicians Organization.

"Now we are seeing that these programs, created for a different purpose, can aid in the response to a public health crisis. The authors note that it will be important to follow trends in the use of e-consults in the coming months. With such significant increases seen in just a few weeks, longer studies may show an even greater impact," Dr Wasfy added.

Notably, the findings of Neelam A. Phadke, Jason Wasfy, and their colleagues have been published in the Journal of General Internal Medicine.

The investigators compared the use of in-person consults and e-consults before and after March 11, the day the governor of Massachusetts declared a COVID-19–related state of emergency. While both types of consult requests declined after March 11, the in-person consults declined more than the e-consults, resulting in an increase in e-consults from 8.5% of all consults before March 11 to 19.6% after March 11. Therefore, the proportion of e-consults requested more than doubled.

In addition, this care can be provided in a manner that does not require patients to forgo physical distancing measures or health care systems to invest in additional personal protective equipment.