Primary care physicians often send their patients to specialists when they need an expert’s opinion about a condition.
But the transfer of medical records and delays in patients scheduling an appointment with a specialist can take weeks or months. The additional cost and travel time incurred by the patient for a second doctor visit also keeps patients waiting.
Electronic consultations, also known as e-consults, are closing those time gaps by providing specialists immediate and virtual access to patient records, while saving patients from another trip to a doctor.
These time-saving factors are especially beneficial to patients diagnosed with mesothelioma, a rare asbestos-related cancer that carries an average life expectancy of nine to 24 months. Treatment for these patients may be improved with faster access to specialists using e-consults.
A 2012 study conducted at the Center for Innovation at the Mayo Clinic noted the value of e-consults “when used judiciously for selected conditions, as done at Mayo, primary care providers and specialists regard the practice as useful and satisfying most of the time.”
However, researchers pointed out the disadvantages: “The specialist only sees the medical record and not the person, the cost is clearly in the assumption that the medical record adequately represents all that a specialist would observe in a direct personal encounter with the patient.”
Although the practice is in its beginning stages, several recognized mesothelioma centers across the U.S. utilize this novel approach to consultations. For veterans, who encompass nearly one-third of all mesothelioma patients, there are a handful of VA healthcare systems that provide the e-consult service.
How Do E-consults Work?
Electronic consultations work by helping primary care physicians (PCP) efficiently discuss a patient’s medical records with specialists, usually located miles away, to gain insight and evaluate about possible treatment options.
For example, a PCP can remotely send questions or recommendations about a mesothelioma diagnosis or therapeutic concern to a specialist through secure email or web applications like electronic medical record (EMR) systems. Specialists can respond quickly, often increasing the speed in which treatment plans are prepared and executed.
It’s important to note this technology is not for patients to consult virtually with their doctors. As the technology develops, electronic consultations may be mainstreamed in conversations between doctor and patient.
Benefits of E-Consults for Patients and Physicians
Patients and physicians can experience benefits from this technology through financial savings, improved care and convenience.
E-consults benefit patients by:
- Decreasing their time between visits.
- Saving money on care.
- Reducing stress while waiting for referrals.
- Processing results faster for quicker treatment.
- Increasing access to treatment options.
Benefits for PCPs and specialists:
- Sharing expertise with specialists.
- Rapid clarification of questions between specialists and PCPs.
- Basic questions addressed without actual visit.
- Decreased number of inappropriate referrals.
- Flexible time frame for working on cases.
- Improved continuity of care.
Treatment Centers Offering E-Consults
A handful of mesothelioma treatment centers across the country provide e-consult services, including:
- Brigham and Women’s Hospital: The facility is located in Boston, Massachusetts, and is home to the well-known International Mesothelioma Program.
- Mayo Clinic Health System in Owatonna: Part of the Mayo Clinic family of hospitals in Minnesota.
- Dana-Farber Cancer Institute: The largest comprehensive cancer center in the nation designated by the National Cancer Center Institute.
Surgical oncologist Charles Conway, M.D., who specializes in abdominal cancers, including peritoneal mesothelioma, at the Ochsner Cancer Institute in New Orleans, says the center is interested in using e-consults to make things easier for patients and doctors unfamiliar with mesothelioma.
Because one in three mesothelioma patients is a veteran, it’s important they have easy access to VA-accredited centers that can provide them treatment.
About 40 percent of veterans in the U.S. live in rural communities, making it difficult for them to easily access specialized health care. As more VA health care systems use e-consults, they can deliver faster service, referral processes and initiation of treatment plans for veterans.
While not all VA health care systems are equipped to treat veterans with mesothelioma, they do provide quality care for other conditions.
These centers may not focus on the asbestos-related disease, but they offer veterans e-consults:
- Ralph H. Johnson VA Medical Center in Charleston
- John D. Dingell VA Medical Center in Detroit
- James J. Peters VA Medical Center in the Bronx
- Northern Arizona VA Healthcare System
E-consults are in the beginning stages, but users of the system believe more family doctors and specialists at cancer centers across the nation will start using it as the technology evolves, and perhaps one day allow patients to meet virtually with their doctors.