Abstract Details

Title Evaluation of the Impact of Neurology Electronic Consults (E-consults): Experiences of a Neurology Resident Clinic in a County Hospital

Topic General Neurology

Presentation(s) S3 - General Neurology 1 (1:00 PM-1:12 PM)

Poster/Presentation
Number 001

Background The average wait time for an in-person new patient consultation in a neurology clinic at Parkland hospital is five months. The neurology clinic began utilizing electronic consults (e-consults) in March 2019. E-consults provide formalized recommendations regarding pertinent diagnostics or treatment recommendations to requesting outpatient providers.

Objective Examine the utility and characteristics of electronic consults utilized in a county hospital neurology clinic.

Design/Methods E-consults to the neurology clinic were reviewed from January 1, 2021 to September 31, 2021. Outpatient providers provide the consult question with relevant information, and neurology physicians (including residents and board certified attendings) review the question and patient’s medical history. Consultants document a diagnosis, possible recommendations, and rationale for recommendations. The consultants provide a synchronous response to the appropriateness of the consult: whether any unnecessary workup was identified, a clinic visit was avoided, and total time spent completing the e-consult. After the specialist completes the response and survey, referring providers are sent the recommendations. We utilized descriptive statistics for this study.

Results 528 e-consults were reviewed. The most frequent e-consult referrals were for headache (22%; n=114), stroke/neurovascular diagnoses (21%; n=110) and neuropathy (11%; n=58). 94% of e-consults were answered in 1 day. >90% of e-consults took <15 minutes to complete. The physicians surveyed determined that 84% of e-consults were deemed appropriate questions, and 16% were deemed not appropriate, most commonly due to high complexity.

Conclusions E-consults provide increased access to care which is vital in health systems that provide care to vulnerable populations. 94% of e-consults were answered in 1 day as opposed to the 5-month average time for an in-person visit. An e-consult takes approximately 15 minutes or less to complete, which improves efficiency and access to care. By combining these different metrics, we generated compelling evidence supporting and expanding the use of e-consults in a neurology residency training clinic.

Authors/Disclosures
Lauren Tardo, MD (UT Southwestern Medical Center) PRESENTER	Dr. Tardo has received personal compensation in the range of $500-$4,999 for serving as a Consultant for EMD Serono. Dr. Tardo has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for NeurologyLive. Dr. Tardo has received personal compensation in the range of $500-$4,999 for serving as a Panel member with CanDoMS. Dr. Tardo has a non-compensated relationship as a Tardo with The MOG Project that is relevant to AAN interests or activities.
Melissa Huynh, MD (UT Southwestern)	Dr. Huynh has nothing to disclose.
Siegfried Hirczy, MD	An immediate family member of Dr. Hirczy has received personal compensation for serving as an employee of Meta. Dr. Hirczy has received personal compensation in the range of $500-$4,999 for serving as a Author with Slack Enterprises.
Kyle M. Blackburn, MD (University of Texas Southwestern Medical Center)	Dr. Blackburn has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for TG Therapeutics.
Amber Salter, PhD (UT Southwestern Medical Center)	Dr. Salter has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Gryphon Bio. Dr. Salter has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Abata Therapeutics. Dr. Salter has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sora Neuroscience. Dr. Salter has stock in Owl Therapeutics. The institution of Dr. Salter has received research support from National Multiple Sclerosis Society. The institution of Dr. Salter has received research support from Department of Defense Congressionally Directed Medical Research Program. The institution of Dr. Salter has received research support from Consortium of Multiple Sclerosis Centers. The institution of Dr. Salter has received research support from Multiple Sclerosis Society of Canada.
Shaida Khan, DO (UT Southwestern Medical Center)	Dr. Khan has received personal compensation in the range of $500-$4,999 for serving as a Consultant for UCB pharma. Dr. Khan has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Argenx. Dr. Khan has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for UCB pharma. Dr. Khan has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Chamblee Ryan .