The impact of hematology electronic consultations on the management of iron deficiency

Abstract

AbstractObjectivesDelays in the evaluation and treatment of iron deficiency can lead to increased disease‐related morbidity and mortality. Electronic consultation (e‐consult) is a referral modality that allows providers quicker access to recommendations from a specialist based on electronic chart review. While the use of e‐consult is expanding in classical hematology, gaps exist in the understanding of patient outcomes related to its use for iron deficiency.MethodsWe randomly selected 200 e‐consults and 200 traditional referrals from 3,336 hematology referrals for iron deficiency at a single center. The primary outcomes of the retrospective analysis were: time to completion of the referral, and time to treatment with intravenous iron. Secondary outcomes included recurrence of iron deficiency, need for repeat e‐consult, conversion to in‐person evaluation, and assessment of whether the etiology of iron deficiency was addressed.ResultsE‐consults significantly reduced the time from referral to intravenous iron repletion (e‐consult, 33 days; traditional referral, 68 days; p < .05). Assessment of the underlying etiology occurred in 70.7% of the e‐consult encounters compared to 92.5% of traditional referrals (p < .05).ConclusionsThese findings highlight advantages of e‐consults in improving care delivery in iron deficiency, and identifying gaps that can be improved through practice standardization to ensure equitable, high‐value care.