Doctors turn to free eConsult platforms to reduce diagnostic errors, study finds
- As providers step up efforts to reduce medical errors and misdiagnoses, more physicians are availing virtual consultation tools to get second opinions, a study in npj Digital Medicine shows.
- Researchers looked at physician use of WebMD's free online Medscape Consult between November 2015 and October 2017. During that time, 310,563 physicians accessed the platform — 37,706 of them "active users" who generated a total of 117,346 posts (7,834 original contacts and 109,512 responses).
- The No. 1 specialty area identified by eConsult users as their primary practice area was internal medicine, at 26.9%. Pediatrics, cardiology, obstetrics and gynecology and dermatology rounded out the top five most frequent specialties. The median time to first response was 90 minutes.
The researchers stress that Medscape Consult is not the only online doctor-to-doctor engagement platform. Other crowdsourced platforms include Sermo, Human Diagnosis Project and QuantiaMD. There are also apps like HealthTap and CrowdMed that allow consumers to consult doctors or other health professionals about symptoms and diagnoses.
"Artificial intelligence has been advocated as the definitive pathway for reducing misdiagnosis. But our findings suggest the potential for collective human intelligence, which is algorithm-free and performed rapidly on a voluntary basis, to emerge as a competitive or complementary strategy," the authors write. "While there are certainly more refinements and study of this platform required, we have demonstrated an extraordinary reach and potential for a multispecialty, crowdsourced, global virtual consultation platform at scale for physicians in search of diagnostic input."
The global study, conducted by Scripps Research Institute and WebMD, shows the growing popularity of eConsults with physicians everywhere. While younger doctors made up the bulk of initial queries, the majority of responses (more than 60%) were from physicians aged 61 and older, suggesting "older physicians feel comfortable with and support this type of virtual engagement," the authors write.
A study in JAMA earlier this year found eConsult can significantly improve access to specialists and reduce specialty work for primary care physicians. But it warned also of new workload challenges for eConsult users, such as increased administrative burden, added clinical responsibility and restructured specialty care delivery.
For eConsult to thrive, stakeholders need to realign expectations and improve communications between primary care doctors and specialists, a 2017 New England Journal of Medicine case study at NYC Health + Hospitals concluded. eConsults can also lead to changes in workflow, such as more scheduling shifting from primary care to specialist, which could trigger changes in dedicated staff, according to the study.