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.

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