
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
Author disclosures: no relevant financial relationships.

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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