Table.
Referral Step | Potential Barrier | Examples of Telehealth or Health Information Technology Strategies Addressing Barrier |
---|---|---|
1. Referral Decision |
PCP uncertainty about need for referral or optimal referral | Electronic consultations Electronic messaging |
2. Pre-consultative communication |
Information not sent, not received, or not reviewed | Telehealth-enabled intake with nonphysician staff Electronic consultations |
3. Appointment Scheduling |
Scheduling process barriers | Electronically-transmitted referrals Patient portals |
Lack of appointment availability (e.g., demand exceeds supply; excessive wait times) | Tele-Mentoring Electronic consultations |
|
Difficulty tracking referrals | Electronically-transmitted referrals | |
4. Consultative Visit |
Geographic/travel barriers | Live interactive telemedicine Store-and-forward telemedicine |
Need for urgent or immediate consultation | Live interactive telemedicine (on-demand) | |
5. Post-consultative communication | Patient-subspecialist communication barriers | Remote patient monitoring Patient portals |
Generalist-subspecialist communication barriers | Electronic messaging Tele-Mentoring |