UW Medicine has asked PBSCI to join the growing list of departments participating in Epicare electronic consultations (e-consults). E-consults are consultation requests from primary care providers to specialist designed to be informal, in that the specialist will not have a face-face or other direct contact with the patient. Rather, the specialist receives the consultation question, reviews the medical record, and then replies to the primary care provider with a written recommendation within Epicare. E-consults formalize the historic “curbside” consultation by formatting the question and recommendation in writing via specifically designed e-consultation templates, and are intended to increase access to care of specialists, particularly for straightforward care decisions. Questions that the consultant feels are beyond the scope of an e-consult will be redirected for face-to-face consultation. E-consults are not billed to patients or insurance entities but consultants providing e-consults will receive work RVUs based on the time required to complete the consultation and UW Medicine will reimburse the department for these RVUs.

Our department’s approach for staffing an e-consultation team will be to have several groups of consultants working at the major sites of UW Medicine. The teams will be based in hospital and UW neighborhood clinic consultation teams, with a team at Harborview Medical Center led by Shaune DeMers, MD, and a team for the UW Medical Center and UW Neighborhood Clinics led by Amanda Focht, MD, and Laurel Pellegrino, MD. Overall direction for the e-consults has been set by Mark Snowden, MD, Ryan Kimmel, MD, and Denise Chang, MD. Plans are also underway for having the service available to Hall Health providers and to primary care providers working with Northwest Hospital.