Table 2.

Summary of Three Major Themes from Provider Interviews: Experiences with and Unintended Consequences of eConsult Use

PCP opinions of eConsult use	Unintended consequence
1) Enhanced comprehensiveness and case-based education
• PCPs generally felt it was part of their role to take care of the patient as much as possible in their medical home • Improved patient relationships with patients by more PCP-directed management • Increased comfort and reassurance in managing more complex conditions • Ability for enhancing knowledge and to apply what is learned from eConsult to future patients	• Increased work between visits for PCP, both in communication to patient and carrying out the specialist plan
2) Provider decision-making
• Three factors considered: patient complexity and preference, and type of question and clinical scenario, and a desire for specialty triage • PCPs liked that if they felt a face-to-face visit was needed they could still make a traditional referral • PCPs appreciated that the eConsult was a formalized method for a curbside consult, which allows specialist direct access to medical record and capture of effort	• Use of eConsult as a triage mechanism for patients to be seen sooner than a traditional referral
3) Implementation into routine practice
• Creating buy-in from PCPs through education about program goals • Training to ensure that specialist responses are timely, adequate, and professional is needed when onboarding a new specialty • Use of conferences and newsletters can help PCPs who may be hesitant to send their first eConsult	• Lack of understanding of goals and incentives promoted thoughts/feelings that burden was being shifted to primary care • If specialist responses are perceived as substandard it could negatively influence future use