Will EHRs trigger 'electronic consultations'?

By Jeff Rowe
09:22 AM

Think of EHRs, and probably the first thing that comes to mind is the increased ease of sharing health information between healthcare providers. As for the second thing, well, that’s where it gets interesting.

A recent report by researchers associated with Kaiser Permanente looks at the possibility of EHR technology leading to more doctor-patient meetings that take place in cyberspace rather than in the same physical location. In “Comparing virtual consults to traditional consults using an electronic health record: an observational case control study", recently published at BioMedCentral, the researchers begin by noting that while “patients have typically received health care through face-to-face encounters. . . .expansion of electronic communication and electronic health records (EHRs) provide alternative means for patient and physicians to interact.”

They go on to suggest that “Electronic consultations may complement regular healthcare by providing ‘better, faster, cheaper’ processes for diagnosing, treating, and monitoring health conditions. Virtual consultation between physicians may provide a method of streamlining care, potentially saving patients the time and expense of added visits. The purpose of this study was to compare physician usage and patient satisfaction with virtual consultations (VCs) with traditional consultations (TCs) facilitated within an EHR.”

In brief, the report presents a range of preliminary findings which might best be described as “food for thought” as policymakers and providers ponder the potential changes in healthcare delivery that will come with the spread of health IT.

To our eyes, what’s interesting is that while the patients involved in the study reported being satisfied with the care they received via VCs, “the vast majority of study physicians relied on TCs, perhaps out of habit, comfort with traditional means of consultation, or slow adaptation of a new workflow. They seemed to somewhat selectively apply VCs, specifically by opting for TCs for confirmation of diagnosis, initiating a new treatment, or assuming care of the patient.”

In other words, one takeaway from the study is that providers are inclined to be cautious when it comes to changing how they interact with their patients, which is not necessarily a bad thing. Moreover, the report’s authors are quite clear about the preliminary nature of their research, and they point to several other angles that need to be studied before anyone can point to the obvious advantages, or at least a lack of disadvantages, to increased use of virtual, rather than on-site, interaction between doctors and the patients for whom they are caring.