econsultations

An econsultation (e-consult) is a remote medical consultation conducted through electronic communication. It can occur between patients and clinicians or between clinicians and specialists. Most often it is asynchronous, allowing a clinician to submit a structured query with relevant data to a specialist, who replies with guidance, management options, or a recommended referral within a defined timeframe. Formats include secure patient portals, secure messaging, email, and, in some systems, video or telephone components.

In primary care, econsultations are used to obtain specialist input, triage referrals, and enable timely management of conditions without an in-person visit. They can also support provider-to-provider consultation and care coordination, particularly for chronic disease management, preventive care, or complex cases.

Benefits include reduced wait times, improved access to specialist opinions, decreased unnecessary referrals, faster guidance for patient management, and better documentation within the medical record.

Challenges and considerations include privacy and data security, interoperability with electronic health records, and the digital divide that can limit access for some patients. Reimbursement and regulatory frameworks, medicolegal liability, and ensuring safe, appropriate clinical decision-making are also important. Effective econsultations require clear workflows, triage protocols, patient consent, and integration with existing information systems.

Adoption varies by health system and region, but econsultations are expanding as a method to increase access, efficiency, and coordination of care, with outcomes influenced by design, implementation, and patient population.