Pediatric E-Consults: Access to Specialty Care
- A shortage of pediatric specialists nationwide is causing delays in care, with some children waiting weeks or months for appointments. However, a new UC davis Health study published...
- E-consults, conducted securely through the hospital's electronic health record, allow primary care physicians to consult asynchronously with specialists about a patient's care.
- Ulfat Shaikh, UC Davis Health professor of pediatrics and lead author of the study, noted that the pediatric specialist shortage can lead to longer wait times and poorer...
combatting the pediatric specialist shortage, a recent study unveils how e-consults are revolutionizing pediatric care. Conducted through electronic health records, these e-consults significantly reduce the wait times for specialist advice. Primary care physicians can now consult specialists, streamlining access to vital specialty care and perhaps decreasing the need for in-person visits. Thanks to initiatives promoting e-consults, utilisation has surged.The data shows faster responses and improved efficiency across multiple specialities. This innovative approach offers actionable advice, enhancing the quality of care. E-consults are proving beneficial for families and improving overall healthcare delivery. Discover what’s next …
E-Consults Improve Pediatric Specialty Care Access, Reduce Wait Times
Updated June 7, 2025
A shortage of pediatric specialists nationwide is causing delays in care, with some children waiting weeks or months for appointments. However, a new UC davis Health study published in Clinical Pediatrics indicates that electronic consultations, or e-consults, between primary care pediatricians and specialists can improve pediatric care.
E-consults, conducted securely through the hospital’s electronic health record, allow primary care physicians to consult asynchronously with specialists about a patient’s care. The primary care provider then relays the specialist’s recommendations to the patient and their family. This approach to specialty care aims to address the growing need for accessible pediatric specialists.
Dr. Ulfat Shaikh, UC Davis Health professor of pediatrics and lead author of the study, noted that the pediatric specialist shortage can lead to longer wait times and poorer health outcomes, especially for children with chronic conditions. “With e-consults, primary care physicians can ask for a second opinion, mitigating the need for families to make an in-person appointment with that specialist,” Shaikh said.
The study took place at UC Davis Health’s pediatric health clinic, wich serves approximately 2,800 children and adolescents annually. From January to December 2023,primary care pediatricians requested e-consults with specialists in various fields,including allergy and immunology,dermatology,endocrinology,gastroenterology,infectious diseases,nephrology,and pulmonology.
A key focus of the study was increasing awareness of e-consults.even though implemented at UC Davis Health in 2014, usage was lower than expected. The study team undertook several initiatives to educate and engage clinicians, including outreach to the medical community and collaboration with each specialty to develop specific e-consult protocols. The electronic health record system was also adjusted to highlight the e-consult option.
These efforts led to a important increase in e-consult utilization,rising from 14% to 43%. During the study period, 65 e-consults were conducted, primarily for conditions such as skin eruptions, infantile hemangiomas, alopecia, and seizures. Dermatology was the most frequently consulted specialty. Subspecialists responded with recommendations in an average of one day,compared to the average 59-day wait for in-person appointments.
The research team also interviewed primary care pediatricians, specialists, and a referral coordinator to gather qualitative feedback on their experiences with e-consults.
“We found that e-consults were a big win for everyone,” Shaikh said.”For families, they reduced time away from work and school, and also transportation to and from visits.Primary care physicians were able to get more timely advice, giving them more data to provide better care. Specialists could use e-consults to order diagnostic tests before seeing patients in person, making those visits more efficient.”
E-consults are notably beneficial for UC Davis Health, which serves a large and rural area, as they reduce the need for patients and families to travel long distances for appointments.
“We found that e-consults helped primary care pediatricians get actionable advice from pediatric specialists for their patients,” said Shaikh. “They reduced the wait times, as well as the need for in-person visits. That improves quality and value by making health care delivery more timely and efficient.”
What’s next
the UC Davis Health team plans to expand the e-consult programme to other specialties and continue monitoring its impact on patient outcomes and healthcare efficiency.