With great interest I read the article “Electronic Consult Experience: Making Health Care More Accessible and Convenient for Veterans.”1 The author, Barbara J. Siepierski, MD, described the successful implementation of the electronic consultation (e-consult). As a pulmonary staff physician at the James H. Quillen VAMC in Mountain Home, Tennessee, in VISN 9, I would like to add my experience as a subspecialist for the adaptation of the e-consult systemwide in the VA.
Several years ago, it became my responsibility to screen all the outpatient pulmonary consultations at the Mountain Home VAMC. The large number of outpatient consultations the pulmonary section received overwhelmed our physician and clinic resources and dictated that the individual veteran be prioritized. Also, it was hoped that screening the outpatient pulmonary consultations would ensure that laboratory and radiographic studies would be completed before the veterans’ clinic visits, thereby avoiding unnecessary visits and congestion of the pulmonary outpatient clinic.
When the e-consult was presented to the staff at the Mountain Home VAMC, many individual practitioners, including myself, were skeptical. I thought that nothing could or should replace the face-to-face visit and worried about medical-legal aspects of adopting this process. However, the benefits to our subspecialty pulmonary outpatient clinic have been enormous. There is now no wait time for new face-to-face consultations into the pulmonary outpatient clinic. There is no longer a need to prioritize the veterans into the pulmonary outpatient clinic.
It is my hope that the entire VA system will soon share the experience as expressed by Dr. Siepierski in VISN 11. This may be another example where the VA is leading the nation in health care.
Ryland P. Byrd Jr, MD
James H. Quillen VAMC
Mountain Home, Tennessee
Disclaimer
The opinions expressed in reader letters are those of the writers and do not necessarily reflect those of Federal Practitioner, Frontline Medical Communications, the U.S. Government, or any of its agencies.
Reference
1. Siepierski BJ. Electronic consult experience: Making health care more accessible and convenient for veterans. Fed Pract. 2013;30(12):38-40.