eConsults

An eConsult, or electronic consultation, is a secure, asynchronous exchange between a primary care clinician and a specialist to obtain expert advice about a patient’s condition. The goal is to provide timely specialty input without an in-person referral, while keeping the patient’s care anchored in primary care when possible.

Typically, the primary clinician submits a case via a secure platform with the patient’s history, exam findings, and relevant tests. The specialist reviews the information, offers a management plan, and determines whether an in-person visit is needed. The PCP then communicates the plan to the patient and arranges any follow-up.

eConsults can be embedded in electronic health records or delivered through standalone portals. Implementation varies by health system, and reimbursement policies differ across regions. Examples include the U.S. Veterans Affairs eConsult program and provincial services such as Ontario’s.

Benefits reported include faster specialist input, fewer unnecessary referrals, clearer primary care plans, and improved patient satisfaction. Evidence on cost savings and broader outcomes is mixed and tends to depend on setting and specialty.

Limitations include dependence on complete information, potential added workload for clinicians, privacy considerations, and uneven reimbursement. Successful adoption requires clear workflows, interoperable IT systems, and ongoing evaluation of impact and patient outcomes.