Triage to Advice Only for Referring Providers: A Pilot Project Using Formal Consensus Methods to Establish Appropriate Patients for Electronic Consultations

Background Access to equitable, timely consultations by Endocrinologists remains problematic, requiring optimization of referral pathways to ensure rapid advice and reduce wait times. Objective Our goal was to develop consensus amongst endocrinologists regarding referral scenarios that are most amenable to advice only (eConsultation) using formal consensus methods and to examine consistency across 2 distinct divisions of Endocrinology. Methods Using the nominal group technique, members of the Division of Endocrinology at site 1, generated 58 clinical scenarios considered appropriate for advice back to the referring provider in place of an in person visit. A Modified Delphi process was conducted to indicate the level of agreement for each scenario. The rating scale included 5 items; strongly disagree, disagree, neutral, agree or strongly agree on whether the scenario is suitable for eConsultation. Three Modified Delphi rounds were conducted independently at 2 divisions of Endocrinologists at academic institutions in different cities and compared to identify areas of consensus or no consensus. We defined consensus as 70% or more of participants selected agree or strongly agree and fewer than 20% selected disagree or strongly disagree. Results At site 1, among 12 initial respondents, consensus was obtained for 45 items (78%), of which 38 items were voted appropriate for eConsultation, 7 items were voted as not appropriate, and 13 had no consensus. At the second site, among 13 initial respondents, consensus was reached for 48 items (83%) of which 34 were voted as appropriate while 14 were considered not appropriate for eConsultation and no consensus was found for 10 items. Major discordance between sites occurred for only 2 items. Conclusion There was a high degree of consensus at 2 academic medical centers identifying clinical scenarios appropriate for advice back/eConsultation in place of an appointment utilizing a Modified Delphi process. Identifying scenarios with consensus supports consistent decision making for eConsultation among clinicians involved in triaging referrals for ambulatory care Endocrinology.

• Publication year

  2025

• Venue

  AACE endocrinology and diabetes

• Publication date

  2025-08-01

• Fields of study

  Medicine

• Identifiers
  DOI 10.1016/j.aed.2025.08.002PMID 41467135PMCID 12744785
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar, PubMed

• No claims are published for this paper.

• No concepts are published for this paper.

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