ORIGINAL RESEARCH
Kaitlin Kuznacic, PharmD; Cory P. Coffey, PharmD, BCACP, BCPP; Kevin Goist, MD; Kelli D. Barnes, PharmD, BCACP
Corresponding Author: Kelli D. Barnes, PharmD, BCACP; The Ohio State University Division of General Internal Medicine.
Email: Kelli.Barnes2@osumc.edu
DOI: 10.3122/jabfm.2022.220394R2
Keywords: Pharmacists, Primary Health Care, Referral and Consultation, Remote Consultation, Retrospective Studies, Workforce
Dates: Submitted: 11-18-2022; Revised: 02-14-2023; 02-27-2023; Accepted: 03-06-2023
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BACKGROUND: Electronic consults (eConsults) allow for asynchronous, consultative, provider-to-provider communication. A pharmacy run eConsult service was initiated in a group of primary care clinics comprised of 60 attending internal medicine primary care physicians (PCP), 100 internal medicine residents, and 10 pharmacists serving over 60,000 patients. This study aims to describe (1) the number and types of eConsults placed to pharmacists; (2) the number of eConsults completed, converted to an office visit, or declined by a pharmacist; (3) the number of pharmacist recommendations made and implemented within 30 days of eConsult placement; and (4) PCP perceptions of the eConsult service.
DESIGN: A retrospective chart review of all pharmacy eConsults placed between February 25, 2020 and July 6, 2021 was completed to describe eConsult utilization. Additionally, an electronic survey was used to assess attending physician perceptions of pharmacy eConsults.
RESULTS: A total of 513 eConsults were placed during the study period. The most common type of eConsult placed was “cost savings/formulary med questions” (110, 21.4%). Of the 435 eConsults completed by a pharmacist, 341 (78%) eConsults resulted in specific recommendations for medication therapy and 335 (98%) of these recommendations were implemented by the PCP. A total of 17 PCPs completed the survey assessing the perceived benefits of pharmacy eConsults. The top perceived benefits were improvement in patient outcomes (15, 88%) and ability to save provider time spent on patient care (14, 82%).
CONCLUSIONS: eConsults to pharmacists resulted in specific drug therapy recommendations that were routinely implemented by PCPs and perceived as a benefit to both providers and patients.