Emergency Department Clinician Perspectives on an EMR-Adjacent Microsoft Teams Consultation Workflow.

Background: Communication failures in the emergency department (ED) can delay consultations and worsen crowding. Hospitals now use phone-based systems, EMR-integrated secure chat, and EMR-adjacent messaging platforms for consultant communication, but few studies describe ED clinician experience with these workflows. Objective: To describe ED clinicians' perceived acceptability of, and experience with, an EMR-adjacent Microsoft Teams-based consultation workflow used alongside a telephone-based consultation pathway. Methods: We conducted a single-center post-implementation survey of clinicians who used a Microsoft Teams consultation workflow in an academic ED. The primary analysis focused on ED clinician responses; consulting clinician responses were reported descriptively because of the low estimated non-ED response rate. Results: Of 121 respondents, 82 were ED clinicians, and 39 were consulting clinicians. Among ED clinicians, 78.0% reported high acceptability of the Teams consultation workflow, 85.4% perceived improvements in the workflow, and 89.0% perceived a positive impact on patient care. Delays remained common, with 24.4% of ED clinicians reporting that responses were often delayed. Consulting clinician responses are reported descriptively only because of the low estimated non-ED response rate. Conclusion: ED clinicians reported high perceived acceptability of an EMR-adjacent Microsoft Teams consultation workflow used alongside a telephone-based consultation pathway. These results reflect post-implementation clinician perceptions and do not establish improved consultation timeliness, patient flow, or clinical outcomes.