Implementation of a Urology E-Consult Service at a Safety Net County Hospital

Introduction:We assess the implementation of an e-consult service at a urology clinic in a safety net county hospital.Methods:An e-consult system was introduced in 2018 at our institution. All e-consults for January to December 2018 were collected and data analyzed. Patient demographics were recorded. Total consults, clinic referrals, cystoscopy referrals, need to reschedule and need for followup were compared. Time from referral to in-person clinic visit was collected. Reason for e-consult and final visit diagnosis were placed into urological categories and subcategories.Results:In 2018 472 e-consults were received for 454 patients. The majority were men (62.3%) with a median age of 55 years (IQR 44-63). The majority (52%) were Hispanic. Most patients (69.1%) were scheduled for an in-person clinic visit with 23.9% of these patients scheduled for a cystoscopy. Median time from referral to in-person clinic visit was 39.5 days (IQR 33-50). A quarter of the patients did not require further followup after initial in-person consultation. The majority of e-consults were for hematuria (24%), renal pathologies (20%), and benign prostatic hyperplasia and lower urinary tract symptoms (17%).Conclusions:Implementation of a urology e-consult service is feasible and decreases need for in-person clinic visits.