Project Arkansas eConsultations: Bridging Primary and Specialty Care Through eConsults

Electronic consultations, or eConsults, represent an innovative shift in the health care landscape, offering a way to provide more timely and efficient patient care. eConsults can alleviate the need for in-person consultations with specialists, which can in turn expedite care, reduce costs, and enhance access, particularly in remote or underserved areas. 

Mathematica evaluated the implementation and outcomes of eConsults in Arkansas, a state that has a mix of urban and rural geographic areas with limited access to specialty care and a shortage of specialists. Formative and summative reports documented findings from the pilot. The formative report focused on the initial implementation of eConsults in Arkansas, outlining the strategies, challenges, and opportunities for integrating this innovative solution into the existing health care system. The summative report summarized the pilot’s participation patterns, utilization, and impacts on expenditures.

The analysis of eConsult recipients reveals usage patterns that indicate that patients with specific conditions (for example, diabetes)—and those seeking care in specialties such as dermatology, endocrinology, and neurology—are more likely to receive eConsults, emphasizing that primary care providers are inclined to recommend eConsults for conditions with well-known markers. 

In terms of impact, the eConsult pilot demonstrates anticipated financial savings, with an average $195 reduction in expenditures for key services during the month of the eConsult. This reduction, mainly in specialty care costs, underscores eConsults as a cost-effective alternative, with the absence of adverse events suggesting their safety for deployment in clinical settings.