Interprofessional Electronic Consultations for the Diagnosis and Management of Neuro-Ophthalmic Conditions. Issue 1 (8th March 2023)

• Record Type: Journal Article
• Authors: Xu, Timothy T.; Kung, Felix F.; Lai, Kevin E.; Ko, Melissa W.; Brodsky, Michael C.; Bhatti, M. Tariq; Chen, John J.
• Editors: Fraser, Clare; Mollan, Susan
• Is Part Of: Journal of neuro-ophthalmology. Volume 43:Issue 1(2023)
• Page Start: 34
• Page End: 39
• Publication Date: 2023-03-08
• Subjects: Neuroophthalmology -- Periodicals; 617.7
• DOI: 10.1097/WNO.0000000000001643
• Languages: English
• ISSNs: 1070-8022

Abstract

Abstract : Background: Interprofessional electronic consultation (eConsult) is a telemedicine modality in which consulting providers review outside records and provide recommendations without in-person consultation. The purpose of this study was to describe the utilization of eConsults in the management of neuro-ophthalmic conditions. Methods: Retrospective cohort study of all patients who received an eConsult for a neuro-ophthalmic condition at a single quaternary referral center from 2018 to 2020. Main outcome measures included proportion of eConsults in which sufficient data were provided to the neuro-ophthalmologist to generate a definitive management decision, proportion of patients for whom an in-person neuro-ophthalmology evaluation was recommended, and the eConsult's impact on patient care. Results: Eighty eConsults were conducted on 78 patients during the 3-year study period. Forty-eight (60.0%) subjects were female, mean age was 54 years, and 65 (81.3%) were White. The median time from eConsult request to completion was 4 days (range: 0–34 days). The most frequent eConsult questions were vision/visual field disturbances in 28 (35.0%) cases, optic neuropathies in 22 (27.5%), and optic disc edema in 17 (21.3%). At the time of eConsult, sufficient prior information was provided in 35 (43.8%) cases for the neuro-ophthalmologist to provide a definitive management decision. In 45 (56.3%) eConsults, further diagnostic testing was recommended. In-person neuro-ophthalmology consultation was recommended in 24 (30.0%) cases. Sixty-one (76.3%) eConsults provided diagnostic and/or treatment direction, and 12 (15.0%) provided reassurance. Conclusion: eConsults increase access to timely neuro-ophthalmic care and provide diagnostic and treatment direction to non–neuro-ophthalmology providers when sufficient information is provided at the time of eConsult.