Duke Cancer Institute

 

Duke-Cancer-Institute-390x137

Afreen Shariff, MD, MBBS
Duke Cancer Institute, Duke Endo Oncology Program, Duke Endocrinology
Durham, North Carolina

e-Consults for Immune-Related Toxicities Improve Patient Access and Reduce Costs

Implementing e-consults for patients experiencing endocrine immune-related adverse events (irAEs) improved patient access and reduced healthcare utilization. Time to appointment and hospitalizations were reduced from 61 days to 39 days and from 11% to 2%, respectively. To propel integration and scalability, the next step is to ensure adequate reimbursement from payers for these types of e-consults.

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Presently at Duke Cancer Institute, for patients with cancer, the average wait time to see an endocrine specialist is 87 days. One solution to this challenge is to implement expert triage from an endocrinologist who can review the case via an e-communication based platform. This platform can allow physicians to assess patients sooner and determine the need for an in-person visit. E-communication, also known as an e-consult, is an asynchronous telehealth platform that is a templated order request in an electronic health record (EHR) that allows a specialist to review a case on behalf of another provider to advise on individual patient care.
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