To examine the educational value of neurology electronic consults (e-consults) in a resident continuity clinic at a large safety-net hospital. 

The neurology e-consult service launched in March of 2019. An initial study of e-consult metrics demonstrated that the e-consult service helped streamline patient consultations and provided quick and effective specialist input. In this follow-up study, we expand on our previous work by (1) evaluating the impact on trainee education; (2) understanding the perspective of the providers initiating the e-consult and the impact on their confidence in addressing common neurological issues.

Surveys were sent to neurology trainees and faculty who answer and staff e-consults, respectively. A third survey was sent out to primary care and specialty providers initiating neurology e-consults. Five-point Likert scales were used in the surveys along with a free-text response to allow for additional qualitative content analyses. Descriptive statistics were used to analyze the Likert scale data.

17 neurology trainees and 17 faculty members (77.3% and 51.5% response rates respectively) completed the surveys. The majority of trainees and faculty agreed or strongly agreed that e-consults helped identify knowledge gaps (82.4% and 76.4% respectively), helped build effective communication skills (70.6% and 94.2% respectively), and have an important role in trainee education (88.2% and 94.1% respectively). Primary care and other referring providers (n=34, 35% response rate) agreed or strongly agreed that the e-consult service helped with timely delivery of patient care (71%), helped build confidence in handling common neurological complaints (71.9%), and improved collaboration with the neurology clinic (72.7%). We are still allowing for data collection until the end of this calendar year and anticipate an approximate 40% response rate in all surveys.

E-consults have the potential to provide educational value to trainees as well as empower primary care and specialty providers on addressing common neurological issues.