JMIR Publications

ABSTRACT

Background:

Electronic consultations (eConsults) are an increasingly utilised form of telemedicine that allow a non-specialist provider to seek specialist advice virtually without direct patient–specialist communication. Surgical clinics may see benefits from such forms of communication, but have challenges with need for intervention planning.

Objective:

We aimed to use the Quadruple Aim Framework to integrate published knowledge of surgical outpatient eConsults with regard to efficacy, safety, limitations and evolving use in the era of COVID-19.

Methods:

We systematically searched for relevant studies across four databases (OVID Medline, EMBASE, Scopus, and Web of Science) with inclusion criteria of English language, published in the last 10 years, and data on the outcomes of outpatient surgical eConsults.

Results:

A total of 363 studies were screened for eligibility, of which 33 were included. Most of the included studies were from the USA (n = 23) and Canada (n = 7), with a predominant multidisciplinary (n = 9) focus. The majority were retrospective audits (n = 16), with five studies having a prospective component.

Conclusions:

The surgical eConsult studies indicated a possible benefit for population health, promising safety results, enhanced patient and provider experience, and cost savings compared to the traditional face-to-face surgical referral pathway. Their use appeared more favourable in some surgical subspecialties, and overall efficacy was similar to medical subspecialties. Limited data on their long-term safety and usage in COVID-19 were identified, and this should be the focus of future research.