Table 1. How eConsult and Associated Interventions Aimed to Address Challenges With Prior Referral System^a.

Challenge Before eConsult	Unclear Referral Guidelines/Variation in Referral Practices	No Standard/Timely Way to Ask Questions to Specialist	Difficulty Tracking Patients After Referral	Difficulty Scheduling Appointments	Long Wait Times for Specialty Visits
Relevant intervention	Expected practices to facilitate care by PCPs prior to entering an eConsult	eConsult created platform for PCPs to dialogue with specialists	eConsult system tracks outcomes of in-person visit requests	Centralized scheduling system that directly contacts patient after eConsult dialogue completed	eConsult mandated use to allow specialist triage of referrals, potentially resolving requests without in-person visit
PCP perceptions before eConsult and associated interventions	NA	“You weren't able to have a dialogue with the specialists about what studies that they wanted or what test that they wanted done before their referral, before they evaluated the patient.”	“Before eConsult, it was a little bit of a black hole in terms of what happened to your referral. We wouldn't really get much feedback and a lot of the times referrals would sit for a long time…until months later.”	“Before… our patients would sometimes wait a year or more for an appointment to be scheduled and then they would still wait another couple of months for the appointment to actually happen.”

Abbreviations: NA, not applicable; PCP, primary care practitioner.

^aeConsult is an electronic system for PCPs to submit clinical inquiries to specialists for management via electronic dialogue. Requests can either be resolved through dialogue alone or converted to face-to-face referrals.