Triaging general practitioner referrals for specialist review to eConsultant – a pilot study

Abstract

Background eConsultant is an asynchronous, digital, clinician-to-clinician advice service, giving general practitioners rapid remote access to specialist support for patient care. This study aimed to assess the feasibility, acceptability, and appropriateness of a model triaging selected endocrinology and neurology specialist outpatient referrals to eConsultant in an Australian healthcare setting. Methods The proof of concept was conducted for general practitioner (GP) referrals to Mater Hospital Brisbane. The evaluation included analysis of clinical data from the eConsultant platform, GP surveys, and qualitative interviews with patients, GPs, and specialist stakeholders. Survey data and qualitative interview transcripts were analysed to understand acceptability and appropriateness of Triaging Referrals to eConsultant (TReC) to patients and providers. Results For 11 months (October 2024–August 2025), 51 (21%) endocrinology and 77 (6%) neurology referrals were triaged to eConsultant. Specialists spent on average 20 minutes completing the response, which was provided to GPs in an average of 3.5 business days (s.d. 2.5). The predominant presenting conditions for referrals were unexpected findings on imaging and migraine for neurology, and osteoporosis and hyperthyroidism for endocrinology. Close-out surveys were received from GPs for 14.8% (n = 19) of referrals triaged to eConsultant and in nine cases GPs reported a change to patient care as a result. Interviews highlighted the benefits to patients, including reduced treatment delays, convenience, and continuity of care. The option for continuing with a face-to-face specialist appointment, following receipt of eConsultant advice, was required and preferred by some GPs and patients. Conclusions TReC is feasible in the Australian context and has the potential to reduce treatment delays.