Interprofessional Consultations (eConsults) in Urology

Introduction:An interprofessional consultation, or eConsult, is an asynchronous form of telehealth whereby a primary care provider requests electronic consultation with a specialist in place of an in-person consultation. While eConsults have been successfully implemented in many medical specialties, their use in the practice of urology is relatively unknown.Methods:We included data from 4 academic institutions: the University of Michigan, University of California-San Francisco, University of Washington and the Montefiore Medical Center. We included every urological eConsult performed at each institution from the launch of their respective programs through August 2019. We considered an eConsult "converted" when the participating urologist recommended a full in-person evaluation. We report eConsult conversion rate, response time, completion time and diagnosis categories.Results:A total of 462 urological eConsults were requested. Of these, 36% were converted to a traditional in-person visit. Among 119 resolved eConsults with data on provider response time available 53.8% were addressed in less than 1 day, 28.6% in 1 day, 8.4% in 2 days, 3.4% in 3 days, 3.4% in 4 days, 1.7% in 5 days, and 0.8% in ≥6 days. Among 283 resolved eConsults with data on provider completion time available 50.2% were completed in 1-10 minutes, 46.7% in 11-20 minutes, 2.8% in 21-30 minutes, and less than 1% in ≥31 minutes.Conclusions:Our study suggests that eConsults are an effective avenue for urologists to provide recommendations for many common nonsurgical urological conditions and thus avoid a traditional in-person visit for low complexity situations. Further investigation into the impact of eConsults on health care costs and access to urological care is necessary.