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Primary Care Psychiatry eConsults at a Rural Academic Medical Center: Descriptive Analysis
Background: Primary care providers serve a crucial role in addressing the mental health needs of many patients. However, there are times when input from a psychiatric specialist may be helpful in supporting the mental health care provided in primary care. Psychiatry eConsults can serve as a valuable...
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Published in: | Journal of medical Internet research 2021-09, Vol.23 (9), p.e24650-e24650 |
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description | Background: Primary care providers serve a crucial role in addressing the mental health needs of many patients. However, there are times when input from a psychiatric specialist may be helpful in supporting the mental health care provided in primary care. Psychiatry eConsults can serve as a valuable tool in providing specialist advice for primary care physicians when direct referral to specialty care is not readily available. Objective: The goal of this study is to evaluate the content and implementation of psychiatric eConsults by primary care providers in a rural academic medical center. Methods: This is a retrospective review of 343 eConsults placed between May 2016 and February 2019 by primary care providers at a single academic medical center. The content of eConsult requests, including patient diagnosis, consult question type, specialist recommendations, patient demographics, the distance of patient and primary care providers from the consulting provider, rate of implementation of the recommendation, and response time, were analyzed. Results: The most common diagnoses associated with eConsults were depression (162/450, 36%) and anxiety (118/450, 26%). The most commonly asked eConsult question was regarding medication management, including medication choice, side effects, interactions, and medication taper (288/343, 84%). More than one recommendation was included in 76% (259/343) of eConsults, and at least one recommendation was implemented by the primary care provider in 94% (282/300) of eConsults. The average time to respond to an eConsult was 26 hours. Conclusions: This study demonstrates that psychiatry eConsults can be conducted in a timely manner and that primary care providers implement the recommendations at a high rate. |
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However, there are times when input from a psychiatric specialist may be helpful in supporting the mental health care provided in primary care. Psychiatry eConsults can serve as a valuable tool in providing specialist advice for primary care physicians when direct referral to specialty care is not readily available. Objective: The goal of this study is to evaluate the content and implementation of psychiatric eConsults by primary care providers in a rural academic medical center. Methods: This is a retrospective review of 343 eConsults placed between May 2016 and February 2019 by primary care providers at a single academic medical center. The content of eConsult requests, including patient diagnosis, consult question type, specialist recommendations, patient demographics, the distance of patient and primary care providers from the consulting provider, rate of implementation of the recommendation, and response time, were analyzed. Results: The most common diagnoses associated with eConsults were depression (162/450, 36%) and anxiety (118/450, 26%). The most commonly asked eConsult question was regarding medication management, including medication choice, side effects, interactions, and medication taper (288/343, 84%). More than one recommendation was included in 76% (259/343) of eConsults, and at least one recommendation was implemented by the primary care provider in 94% (282/300) of eConsults. The average time to respond to an eConsult was 26 hours. Conclusions: This study demonstrates that psychiatry eConsults can be conducted in a timely manner and that primary care providers implement the recommendations at a high rate.</description><identifier>ISSN: 1438-8871</identifier><identifier>ISSN: 1439-4456</identifier><identifier>EISSN: 1438-8871</identifier><identifier>DOI: 10.2196/24650</identifier><identifier>PMID: 34468329</identifier><language>eng</language><publisher>Toronto: Gunther Eysenbach MD MPH, Associate Professor</publisher><subject>Collaboration ; Drugs ; Electronic health records ; Health care access ; Health needs ; Medical diagnosis ; Medical personnel ; Medical referrals ; Medicine ; Mental disorders ; Mental health care ; Mental health services ; Original Paper ; Patients ; Primary care ; Psychiatry ; Reaction time ; Rural areas ; Side effects ; Telemedicine</subject><ispartof>Journal of medical Internet research, 2021-09, Vol.23 (9), p.e24650-e24650</ispartof><rights>2021. This work is licensed under https://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Jade Avery, Dennis Dwan, Gillian Sowden, Matthew Duncan. 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However, there are times when input from a psychiatric specialist may be helpful in supporting the mental health care provided in primary care. Psychiatry eConsults can serve as a valuable tool in providing specialist advice for primary care physicians when direct referral to specialty care is not readily available. Objective: The goal of this study is to evaluate the content and implementation of psychiatric eConsults by primary care providers in a rural academic medical center. Methods: This is a retrospective review of 343 eConsults placed between May 2016 and February 2019 by primary care providers at a single academic medical center. The content of eConsult requests, including patient diagnosis, consult question type, specialist recommendations, patient demographics, the distance of patient and primary care providers from the consulting provider, rate of implementation of the recommendation, and response time, were analyzed. Results: The most common diagnoses associated with eConsults were depression (162/450, 36%) and anxiety (118/450, 26%). The most commonly asked eConsult question was regarding medication management, including medication choice, side effects, interactions, and medication taper (288/343, 84%). More than one recommendation was included in 76% (259/343) of eConsults, and at least one recommendation was implemented by the primary care provider in 94% (282/300) of eConsults. The average time to respond to an eConsult was 26 hours. Conclusions: This study demonstrates that psychiatry eConsults can be conducted in a timely manner and that primary care providers implement the recommendations at a high rate.</description><subject>Collaboration</subject><subject>Drugs</subject><subject>Electronic health records</subject><subject>Health care access</subject><subject>Health needs</subject><subject>Medical diagnosis</subject><subject>Medical personnel</subject><subject>Medical referrals</subject><subject>Medicine</subject><subject>Mental disorders</subject><subject>Mental health care</subject><subject>Mental health services</subject><subject>Original Paper</subject><subject>Patients</subject><subject>Primary care</subject><subject>Psychiatry</subject><subject>Reaction time</subject><subject>Rural areas</subject><subject>Side effects</subject><subject>Telemedicine</subject><issn>1438-8871</issn><issn>1439-4456</issn><issn>1438-8871</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>7QJ</sourceid><sourceid>ALSLI</sourceid><sourceid>BHHNA</sourceid><sourceid>CNYFK</sourceid><sourceid>COVID</sourceid><sourceid>F2A</sourceid><sourceid>M1O</sourceid><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNpdkW9rFDEQxhdRbK39Dgsi-OY0yczuJr4Qjq1_ChWL6BvfhNnspM2xt3smu4X79uZ6RawQmMnk4Td5ZoriXIq3Spr6ncK6Ek-KU4mgV1o38uk_-UnxIqWNEEqgkc-LE0CsNShzWvy6jmFLcV-2FLm8Tnt3G2jOd26nMS3DnEqaSyq_L5GGcu2o521w5Vfug8uFlseZ4_vygpOLYTeHOy7XIw37FNLL4pmnIfH5Qzwrfn76-KP9srr69vmyXV-tHALOK2-wJwX94Xiquw6rDo0S2uUcGgCN3rMXygAYh1IggxDeVOClMJ2Cs-LyyO0n2tjd0Y-dKNj7whRvLMU5uIEtacHU-9xAVkiAZLSs6toJqBthas6sD0fWbum23LtsL_t-BH38MoZbezPdWY2IAiAD3jwA4vR74TTbbUiOh4FGnpZkVVVrhaapdJa--k-6mZaYh3dQNY0BgY3IqtdHlYtTSpH9389IYQ-bt_ebhz-v0Jy7</recordid><startdate>20210901</startdate><enddate>20210901</enddate><creator>Avery, Jade</creator><creator>Dwan, Dennis</creator><creator>Sowden, Gillian</creator><creator>Duncan, Matthew</creator><general>Gunther Eysenbach MD MPH, Associate Professor</general><general>JMIR Publications</general><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QJ</scope><scope>7RV</scope><scope>7U3</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ALSLI</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BHHNA</scope><scope>CCPQU</scope><scope>CNYFK</scope><scope>COVID</scope><scope>DWQXO</scope><scope>E3H</scope><scope>F2A</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1O</scope><scope>NAPCQ</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0002-7250-3403</orcidid><orcidid>https://orcid.org/0000-0001-8032-1872</orcidid><orcidid>https://orcid.org/0000-0001-5450-5766</orcidid><orcidid>https://orcid.org/0000-0001-7959-6617</orcidid></search><sort><creationdate>20210901</creationdate><title>Primary Care Psychiatry eConsults at a Rural Academic Medical Center: Descriptive Analysis</title><author>Avery, Jade ; Dwan, Dennis ; Sowden, Gillian ; Duncan, Matthew</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c434t-f94da23d23d2fa6bb45b49208c6bb373384ffef029339c4104e300f953f109b23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Collaboration</topic><topic>Drugs</topic><topic>Electronic health records</topic><topic>Health care access</topic><topic>Health needs</topic><topic>Medical diagnosis</topic><topic>Medical personnel</topic><topic>Medical referrals</topic><topic>Medicine</topic><topic>Mental disorders</topic><topic>Mental health care</topic><topic>Mental health services</topic><topic>Original Paper</topic><topic>Patients</topic><topic>Primary care</topic><topic>Psychiatry</topic><topic>Reaction time</topic><topic>Rural areas</topic><topic>Side effects</topic><topic>Telemedicine</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Avery, Jade</creatorcontrib><creatorcontrib>Dwan, Dennis</creatorcontrib><creatorcontrib>Sowden, Gillian</creatorcontrib><creatorcontrib>Duncan, Matthew</creatorcontrib><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>Nursing & Allied Health Database</collection><collection>Social Services Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>Social Science Premium Collection</collection><collection>ProQuest Central Essentials</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>Sociological Abstracts</collection><collection>ProQuest One Community College</collection><collection>Library & Information Science Collection</collection><collection>Coronavirus Research Database</collection><collection>ProQuest Central</collection><collection>Library & Information Sciences Abstracts (LISA)</collection><collection>Library & Information Science Abstracts (LISA)</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Library Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest Publicly Available Content database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>Open Access: DOAJ - Directory of Open Access Journals</collection><jtitle>Journal of medical Internet research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Avery, Jade</au><au>Dwan, Dennis</au><au>Sowden, Gillian</au><au>Duncan, Matthew</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Primary Care Psychiatry eConsults at a Rural Academic Medical Center: Descriptive Analysis</atitle><jtitle>Journal of medical Internet research</jtitle><date>2021-09-01</date><risdate>2021</risdate><volume>23</volume><issue>9</issue><spage>e24650</spage><epage>e24650</epage><pages>e24650-e24650</pages><issn>1438-8871</issn><issn>1439-4456</issn><eissn>1438-8871</eissn><abstract>Background: Primary care providers serve a crucial role in addressing the mental health needs of many patients. However, there are times when input from a psychiatric specialist may be helpful in supporting the mental health care provided in primary care. Psychiatry eConsults can serve as a valuable tool in providing specialist advice for primary care physicians when direct referral to specialty care is not readily available. Objective: The goal of this study is to evaluate the content and implementation of psychiatric eConsults by primary care providers in a rural academic medical center. Methods: This is a retrospective review of 343 eConsults placed between May 2016 and February 2019 by primary care providers at a single academic medical center. The content of eConsult requests, including patient diagnosis, consult question type, specialist recommendations, patient demographics, the distance of patient and primary care providers from the consulting provider, rate of implementation of the recommendation, and response time, were analyzed. Results: The most common diagnoses associated with eConsults were depression (162/450, 36%) and anxiety (118/450, 26%). The most commonly asked eConsult question was regarding medication management, including medication choice, side effects, interactions, and medication taper (288/343, 84%). More than one recommendation was included in 76% (259/343) of eConsults, and at least one recommendation was implemented by the primary care provider in 94% (282/300) of eConsults. The average time to respond to an eConsult was 26 hours. Conclusions: This study demonstrates that psychiatry eConsults can be conducted in a timely manner and that primary care providers implement the recommendations at a high rate.</abstract><cop>Toronto</cop><pub>Gunther Eysenbach MD MPH, Associate Professor</pub><pmid>34468329</pmid><doi>10.2196/24650</doi><orcidid>https://orcid.org/0000-0002-7250-3403</orcidid><orcidid>https://orcid.org/0000-0001-8032-1872</orcidid><orcidid>https://orcid.org/0000-0001-5450-5766</orcidid><orcidid>https://orcid.org/0000-0001-7959-6617</orcidid><oa>free_for_read</oa></addata></record> |
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subjects | Collaboration Drugs Electronic health records Health care access Health needs Medical diagnosis Medical personnel Medical referrals Medicine Mental disorders Mental health care Mental health services Original Paper Patients Primary care Psychiatry Reaction time Rural areas Side effects Telemedicine |
title | Primary Care Psychiatry eConsults at a Rural Academic Medical Center: Descriptive Analysis |
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