Article ; Online: Inpatient Electronic Consultations (E-consults) in Allergy/Immunology.
The journal of allergy and clinical immunology. In practice
2020 Volume 8, Issue 9, Page(s) 2968–2973
Abstract: ... of e-consults in allergy/immunology (A/I) inpatient consultations.: Methods: Inpatients ≥18 years ... Background: Electronic consultations (e-consults) are asynchronous clinician-to-clinician ... the cost of penicillin allergy evaluation, if appropriate.: Results: Of the 109 inpatient consults, 78 ...
| Abstract | Background: Electronic consultations (e-consults) are asynchronous clinician-to-clinician exchanges within the electronic health record (EHR). Objective: We sought to demonstrate the utility of e-consults in allergy/immunology (A/I) inpatient consultations. Methods: Inpatients ≥18 years of age for whom an A/I consultation was requested were eligible for an e-consult. An e-consult was completed if considered appropriate by the A/I physician with recommendations made in the EHR. In-person consultation was performed for inpatients if deemed necessary. Likert scale satisfaction data were collected from requesting providers after the e-consultation. Cost was calculated using time-based billing codes plus the cost of penicillin allergy evaluation, if appropriate. Results: Of the 109 inpatient consults, 78 (71.6%) were completed through an e-consult and 31 (28.4%) were completed by an in-person consult. The most common indication for an inpatient consult was evaluation of penicillin allergy in 73 (67%) patients. The most common reason to complete an in-person consult was the need to complete penicillin skin testing in 17 of the 31 (55%) patients. E-consults were completed in less time than in-person consults (15 minutes, interquartile range [IQR]: 10-15 vs 60 minutes, IQR: 45-60, P < .001) and had a shorter turnaround time (1 hour, IQR: 0.5-2 vs 7 hours, IQR: 3-19, P < .001). Management recommendations were followed at a similar rate regardless of type of consult (88% of e-consults vs 96% of in-person consults, P = .162). A total of 97% of requesting providers reported an "excellent" or "good" impression of e-consults. E-consults were less costly than in-person consults. Conclusions: E-consults have utility in providing inpatient A/I consultation and may have advantages over in-person evaluation, while adequately maintaining provider satisfaction. |
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| MeSH term(s) | Drug Hypersensitivity/diagnosis ; Electronic Health Records ; Electronics ; Humans ; Inpatients ; Referral and Consultation ; Remote Consultation | |||||
| Keywords | covid19 | |||||
| Language | English | |||||
| Publishing date | 2020-06-22 | |||||
| Publishing country | United States | |||||
| Document type | Journal Article | |||||
| ZDB-ID | 2843237-X | |||||
| ISSN | 2213-2201 ; 2213-2198 | |||||
| ISSN (online) | 2213-2201 | |||||
| ISSN | 2213-2198 | |||||
| DOI | 10.1016/j.jaip.2020.06.020 | |||||
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| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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