Evaluating Medicaid Urologic Referral Patterns Via Econsult In A Diverse Non-Integrated Network Of Community-Based Health Systems

You have accessJournal of UrologyHealth Services Research: Practice Patterns, Quality of Life and Shared Decision Making I (PD03)1 Sep 2021PD03-07 EVALUATING MEDICAID UROLOGIC REFERRAL PATTERNS VIA ECONSULT IN A DIVERSE NON-INTEGRATED NETWORK OF COMMUNITY-BASED HEALTH SYSTEMS Desiree Sanchez, Alvin Kwong, Waheed Baqai, Sajid Ahmed, and Stanley Frencher Desiree SanchezDesiree Sanchez More articles by this author , Alvin KwongAlvin Kwong More articles by this author , Waheed BaqaiWaheed Baqai More articles by this author , Sajid AhmedSajid Ahmed More articles by this author , and Stanley FrencherStanley Frencher More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001967.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Most patients in the US receive urologic care in their local communities; yet, the majority of published urologic patient data is derived from academic/academic-affiliated centers or large registries. This is problematic given the lack of racially diverse and underserved populations within academic cohorts, and inability to access granular data within registries. Telemedicine services like electronic consultation (eConsult), an electronic, asynchronous provider-specialist consultation system, are now used across various health systems including California’s largest Medicaid network, the Inland Empire Health Plan (IEHP). The IEHP mandates eConsult use for all specialty referrals for its 1.2 million patients. Here, we present the largest analysis of eConsult use in urology and characterize referral patterns in the safety net from a diverse non-integrated network of community-based health systems across Southern California communities. METHODS: We retrospectively reviewed all patients referred via eConsult from 2018-2020. Our main objective was to perform a descriptive analysis of all urologic eConsults within the IEHP since inception of the program. We categorized consult type etiology and measured the final eConsult outcome recommendation (e.g., face-to-face referral, no further action etc). To assess efficiency we measured message count, urologist response time and time to eConsult close. RESULTS: From 5/2018-8/2020, 1205 patients were referred for urologic eConsult. Median age was 53 (IQR 39, 61). Most patients were male (60%). BPH and/or LUTS or Retention and Gender-confirming surgery were the most and least common referral types, respectively (Figure 1). Majority of eConsults resulted in face-to-face recommendation (75%). Median total message count was 2 (IQR 2,3). Urologists responded within 0.4 days (IQR 0.1, 1.2) and spent <5 min to complete an eConsult; eConsults were closed in <1.5 days (IQR 0.3, 8.1). CONCLUSIONS: We report the largest analysis of eConsult use in urology. Its use allows for timely, efficient urologic access in the IEHP and presents a means to assess urologic needs in the community. We had a high rate of in-person conversion suggesting the need to study eConsult implementation and optimization strategies. Source of Funding: HH Lee Research Grant. © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e45-e45 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Desiree Sanchez More articles by this author Alvin Kwong More articles by this author Waheed Baqai More articles by this author Sajid Ahmed More articles by this author Stanley Frencher More articles by this author Expand All Advertisement Loading ...