Trial reportAnnals of family medicine2016
Electronic Consultations to Improve the Primary Care-Specialty Care Interface for Cardiology in the Medically Underserved: A Cluster-Randomized Controlled Trial.
Trial report in Annals of family medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 51 papers, 7 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
51 citing papers in PubMed, 7 syntheses or guidelines pooled it.
- Interventions to improve referrals from primary care to outpatient specialist services for chronic conditions: a systematic review and framework synthesis update.Systematic reviews · 2025Pooled it
- Family Physician-to-Hospital Specialist Electronic Consultation and Access to Hospital Care: A Systematic Review.JAMA network open · 2024Pooled it
- A Bibliometric Analysis and Visualization of Decision Support Systems for Healthcare Referral Strategies.International journal of environmental research and public health · 2022Pooled it
- Mobile technologies to support healthcare provider to healthcare provider communication and management of care.The Cochrane database of systematic reviews · 2020Pooled it
- Electronic consultations (E-consults) and their outcomes: a systematic review.Journal of the American Medical Informatics Association : JAMIA · 2020Pooled it
- Guideline of the Brazilian Society of Cardiology on Telemedicine in Cardiology - 2019.Arquivos brasileiros de cardiologia · 2019Guideline
- Identification, description and appraisal of generic PROMs for primary care: a systematic review.BMC family practice · 2018Pooled it
- Implementation and Impact of the Pulmonary Specialist Health Coach Consultation Model to Improve Care for Patients with COPD.Joint Commission journal on quality and patient safety · 2021Trial
- Trial
- [Effectiveness of a new model of telephone derivation shared between primary care and hospital care].Atencion primaria · 2019Trial
- Development of key performance indicators for a telemedicine setting in Egypt using an electronic modified Delphi approach.BMC health services research · 2025Article
- Processes and outcomes from a clinical genetics e-consultation service managed by a primary care physician champion.Genetics in medicine open · 2024Article
- A qualitative investigation of uninsured patient and primary care provider perspectives on specialty care eConsults.BMC health services research · 2023Article
- Reaching the Frail Elderly for the Diagnosis and Management of Atrial Fibrillation-REAFEL.International journal of environmental research and public health · 2023Article
- Telemedicine Support for Primary Care Providers versus Usual Care in Patients with Heart Failure: Protocol of a Pragmatic Cluster Randomised Trial within the Brazilian Heart Insufficiency with Telemedicine (BRAHIT) Study.International journal of environmental research and public health · 2023Article
- An eConsultant versus a hospital-based outpatient consultation for general (internal) medicine: a costing analysis.BMC health services research · 2023Article
- General Practitioner Use of e-Consultation to Consult Hospital Specialists: Interview Study to Obtain Physician's Perceptions About Digital Interprofessional Communication.Journal of medical Internet research · 2023Article
- Formalizing the curbside: digitally enhancing access to specialty care.Proceedings (Baylor University. Medical Center) · 2023Article
- Implementing a general practitioner-to-general physician eConsult service (eConsultant) in Australia.BMC health services research · 2022Article
- The Use of Electronic Consultations in Outpatient Surgery Clinics: Synthesized Narrative Review.JMIR perioperative medicine · 2022Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeCommunication between specialists and primary care clinicians is suboptimal, and access to referrals is often limited, which can lead to lower quality, inefficiency, and errors. An electronic consultation (e-consultation) is an asynchronous, non-face-to-face consultation between a primary care clinician and a specialist using a secure electronic communication platform. The purpose of this study was to conduct a randomized controlled trial of e-consultations to test its efficacy and effectiveness in reducing wait times and improving access to specialty care.
methodsPrimary care clinicians were randomized into a control (9 traditional) or an intervention (17 e-consultation) arm for referrals to cardiologists. Primary care clinicians were recruited from 12 practice sites in a community health center in Connecticut with mainly medically underserved patients. Two end points were analyzed with a Cox proportional hazards model where the hazard of either a visit or an e-consultation was linked to study arm, sex, race, and age.
resultsThirty-six primary care clinicians participated in the study, referring 590 patients. In total, 69% of e-consultations were resolved without a visit to a cardiologist. After adjusting for covariates, median days to a review for an electronic consultation vs a visit for control patients were 5 and 24, respectively. A review of 6-month follow-up data found fewer cardiac-related emergency department visits for the intervention group.
conclusionE-consultation referrals improved access to and timeliness of care for an underserved population, reduced overall specialty utilization, and streamlined specialty referrals without any increase in adverse cardiovascular outcomes. e-consultations are a potential solution for improving access to specialty care.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.