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Electronic consultations can help primary care physicians manage behavioral health conditions more efficiently and effectively. Here's how.

Fam Pract Manag. 2022;29(4):9-14

This content conforms to AAFP criteria for CME.

Author disclosures: no relevant financial relationships.

e-consult

Nearly 20% of all adults meet the criteria for a psychiatric disorder,1 and with psychiatric specialists in short supply,2 primary care physicians play an essential role in managing their patients' mental health.

But primary care physicians need not do this alone. Electronic consultations (e-consults) can provide valuable support, especially for those who don't otherwise have access to psychiatrists or other behavioral health professionals in their community. All e-consults are not equally effective, however. This article explains the purpose of psychiatric e-consults, based on our collective experience using them for many years, and provides advice on how to make the most of them.

KEY POINTS

  • Psychiatric e-consults are a valuable resource, especially for primary care physicians and patients who have limited access to psychiatrists or behavioral health professionals in their communities.

  • E-consults are more effective when the referring physician asks the consultant specific questions, includes a comprehensive note, uses mental health screening tools, and makes visit documentation easy for the consultant to navigate.

  • E-consults are billable and include work relative value unit credits for the consultant and the referring primary care physician.

WHY USE E-CONSULTS?

E-consults are asynchronous clinician-to-clinician communications, ideally within a shared electronic platform. Unlike a traditional consultant, the e-consultant answers the primary care physician's questions without meeting or interviewing the patient, relying solely on information the referring physician shares, often via the EHR or e-consult platform.3 E-consult use has been increasing in several specialties.3,4

In one study, more than 90% of primary care physicians who used e-consults said they are helpful and improve patient care, and more than 80% said using e-consults increased their own behavioral health knowledge.5 In another study, e-consult users said they implemented at least one of the consultants' recommendations up to 94% of the time.6 E-consults are associated with reductions in psychiatric specialty care costs, face-to-face behavioral health visits, and treatment delays.7,8,9 Overall, consultant response times average 1–3 days, and consultants can respond to some questions much faster, sometimes in a matter of minutes. 6

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