Electronic Preconsultation as a Method of Quality Improvement for Urological Referrals
Open accessAbstract
INTRODUCTION: Preconsultation exchange is a method to promote expedited care among health care providers through communication between primary care providers and specialists before a clinic visit. We evaluated the efficacy of a preconsultation exchange in streamlining patient visits to the urology clinic with an emphasis on resource efficiency in a safety net hospital. METHODS: Between April 1, 2011 and March 31, 2012 there were 1,705 electronic referrals to our urology department. A random sample of 500 referrals was selected for evaluation, of whom 487 patients met study inclusion criteria. Scheduling outcome and preconsultation exchange were evaluated for each chief complaint. RESULTS: Patients with operative or procedural chief complaints, or potential oncologic diagnoses were most likely to be scheduled directly to the urology clinic. Of the 487 patients 36 (7.4%) were treated for benign urological conditions by primary care providers and did not need to be seen in the urology clinic. For 13.5% of patients recommended laboratory and radiological tests were obtained before the initial urology clinic visit as a result of preconsultation exchange. CONCLUSIONS: Electronic preconsultation exchange served as a method of quality improvement by promoting urology clinic efficiency. Unnecessary appointments were limited and the completeness of appropriate laboratory and imaging studies at the initial visit was increased. Health care was streamlined by increased access to urological care and by management of benign urological conditions without a formal clinic visit in appropriate cases.
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The percentage of avoided face-to-face visits ranged from 7.4% to 78%, with most studies reporting between 22% and 68% reductions in face-to-face specialist visits.
“The lowest was 7.4% 43 and the highest 78%, 36 with most studies reporting between 22% and 68% reductions in face-to-face specialist visits.”
From A Systematic Review of Asynchronous, Provider-to-Provider, Electronic Consultation Services to Improve Access to Specialty Care Available Worldwide (2019) · cites this paper as [43]
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“✗ “A key barrier to widespread adoption of preconsultation exchange is the development of reimbursement models” 77 (p. 174).”
- Authors
- McGeady, J. B., Blaschko, S. D., Brajtbord, J. S., Sewell, J. L., Chen, A. H., & Breyer, B. N.
- Affiliations
- San Francisco General Hospital (US)
- Venue
- Urology Practice
- Published
- 2014-11
- Volume
- 1
- Issue
- 4
- Pages
- 172-175
- ISSN
- 2352-0779 (ISSN-L)
- OpenAlex
- W2029906322
- Semantic Scholar
- 441a69e1a301d2ac102742ab4b415795e02d54d8
- Cited by
- 7
- References
- 13
- Citations by year
- 2026: 1 · 2022: 1 · 2020: 2 · 2019: 1 · 2018: 1 · 2017: 1
- FWCI
- 0.73
- Type
- journal article
- Language
- en
- Open access
- green
- escholarship.org
- Locations
- Urology Practice (publishedVersion)
- PubMed (publishedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Topics
- Social Sciences › Business, Management and Accounting › Organizational Behavior and Human Resource Management › Healthcare Systems and Technology
- Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
- Health Sciences › Health Professions › Emergency Medical Services › Healthcare Operations and Scheduling Optimization
- Keywords
- urology referral, appointment scheduling, safety-net hospitals, quality improvement
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