Electronic consultations (eConsults) allow primary care providers to ask clinical questions of a network of specialists and get an answer back within hours. Studies have shown the clear impact eConsults can have, including decreasing wait times for specialist visits and preventing unnecessary referrals. Those effects can be pronounced in the safety net, where specialists are especially hard to find and access.

Seeking to improve care access and quality, in 2015 Community Health Center Network (CHCN), a partnership of community health centers serving 140,000 Medi-Cal members in Alameda and surrounding counties, began offering eConsults via RubiconMD, a CHCF investee. CHCN recently sought to assess how primary care providers perceive the platform across a range of criteria, including its ease of use, effect on patient care, and impact on workflow. The evaluation, conducted by John Snow Inc. and funded by CHCF, included survey responses from 139 providers and 10 in-depth interviews and is available to download below.

Key Findings

Perceptions of eConsults among active users were largely positive. Among the 106 respondents classified as frequent users¹ of RubiconMD’s eConsults platform:

• 51% report an increase in job satisfaction resulting from use of the platform
• 70% feel eConsults have improved their knowledge, confidence, and skill in treating specialty conditions
• 82% believe using eConsults improves their patients’ quality of care
• 90% agree that the platform is simple and easy to use

This resource assists me in providing quality care to marginalized patients with limited resources, addressing not only individual health needs, but also . . . the poor outcomes caused by systemic inequity and social injustice around access to quality health care.

Providers did identify some barriers to making optimal use of eConsults:

• Takes more time and work than simply referring the patient to a specialist
• Frustration with certain features of the eConsults platform, such as suboptimal integration with the EHR
• Skepticism and discomfort with relying on the counsel of an anonymous specialist

Nonetheless, many providers that express some concerns still acknowledge the powerful impact that eConsults can have on patient access to specialty care. RubiconMD has also undertaken efforts to further optimize its platform and make it even easier for providers to choose an eConsult over a referral — when the circumstances call for it.

1. Frequent users were defined as those having requested at least four eConsults per month on the platform, having completed 100+ total eConsults, and/or having eConsulted 15+ specialties.