Evaluating the impact of an eConsult platform on specialty care access for Medicaid patients
Open accessAbstract
BACKGROUND: Healthcare access disparities persist, particularly among Medicaid patients in regions like the Inland Empire, California. These patients often face prolonged wait times for primary and specialty care, compounded by difficulties in scheduling with providers. Leveraging eConsult platforms offers a potential solution to improve specialist care accessibility. This study examines the impact of the Inland Empire Health Plan's (IEHP) eConsult services on enhancing interactions between primary care providers (PCPs) and specialists and improving patient care. METHODS: We analyzed 2,505 eConsults conducted between January and June 2022 within the IEHP, focusing on dermatology, pulmonology, and urology. Each eConsult was categorized based on closure outcomes, advice provided, and authorization status. We cross-referenced eConsult data with claims and authorization records to determine encounter completion, particularly whether a face-to-face specialist visit occurred. RESULTS: Only a fraction of eConsults (27% dermatology, 25% pulmonology, 37% urology) resulted in specialist advice. In cases where eConsults did not suffice, specialists recommended in-person follow-up; however, a significant portion of patients (57% dermatology, 71% pulmonology, 53% urology) did not receive in-person specialty care. CONCLUSION: This study highlights the potential of eConsults in improving specialty care access for Medicaid patients in underserved regions. While eConsults show promise in expediting specialist access, challenges such as varying PCP utilization and the need for in-person visits persist. Addressing these issues with standardized protocols and better triaging can significantly reduce healthcare disparities and improve patient outcomes.
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eConsults enable asynchronous communication between primary care clinicians and specialists without in-person visits.
“eConsults enable asynchronous communication between PCCs and specialists without in-person visits.5”
From Large Language Model–Generated Electronic Consultations: A Blinded Comparative Study of OpenEvidence and Gastroenterologist Electronic Consultations (2026) · cites this paper as [5]
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Research works printed but not linked: 8
- Manuel JI. Racial/ethnic and gender disparities in health care use and access. Health Serv Res 2018;53:1407-29.
- Newman M, Paci J. Inland empire: increasing Medi-Cal coverage spurs safety-net growth. Published 2021. Accessed April 3, 2024. Available at: https://www.chcf.org/publication/inland-empire- increasing-medi-cal-coverage-spurs-safety-net- growth/. doi: 10.3122/jabfm.2024.240322R1 eConsult and Specialty Care Access for Medicaid Patients 597 copyright. on 25 August 2025 by guest. Protected by http://www.jabfm.org/ J Am Board Fam Med: first published as 10.3122/jabfm.2024.240322R1 on 25 August 2025. Downloaded from · DOI
- Wang RF, Trinidad J, Lawrence J, et al. Improved patient access and outcomes with the integration of an eConsult program (telederma- tology) within a large academic medical center. J Am Acad Dermatol 2020;83:1633-8.
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- Deeds SA, Dowdell KJ, Chew LD, Ackerman SL. Implementing an opt-in eConsult program at seven academic medical centers: a qualitative analysis of primary care provider experiences. J Gen Intern Med 2019;34:1427-33. 598 JABFM May-June 2025 Vol. 38 No. 3 http://www.jabfm.org copyright. on 25 August 2025 by guest. Protected by http://www.jabfm.org/ J Am Board Fam Med: first published as 10.3122/jabfm.2024.240322R1 on 25 August 2025. Downloaded from
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Stephenson, C. R., Varayil, J. E., Salonen, B. R., Wight, E. C., Sang, P. D., Ghosh, A. K., Shung, D. L., Croghan, I. T., Schroeder, D. R., & Hurt, R. T. (2026) · Mayo Clinic Proceedings: Digital Health · doi:10.1016/j.mcpdig.2026.100404
- Authors
- Thind, B. S., Maddalena, M., Baqai, W., Frencher, S. K., & Jih, W. W.
- Affiliations
- University of California, Los Angeles (US)
- Venue
- The Journal of the American Board of Family Medicine
- Published
- 2025-05
- Volume
- 38
- Issue
- 3
- Pages
- 592-598
- ISSN
- 1557-2625 (ISSN-L)
- 1558-7118
- PMC
- PMC12616798
- OpenAlex
- W4413564903
- Cited by
- 1
- References
- 0
- Citations by year
- 2026: 1
- FWCI
- 1.24
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Locations
- The Journal of the American Board of Family Medicine (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Business, Management and Accounting › Organizational Behavior and Human Resource Management › Healthcare Systems and Technology
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Health Sciences › Health Professions › General Health Professions › Primary Care and Health Outcomes
- Keywords
- e-consultation, access to specialist care, Medicaid patients, health care access disparities, dermatology, respiratory medicine, urology, specialist referral, underserved regions, care coordination
- MeSH terms
- Adult, California, Dermatology, Female, Health Services Accessibility, Humans, Male, Medicaid, Primary Health Care, Specialization, United States, Remote Consultation, Healthcare Disparities
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