Table 1

Comparison of traditional in-person subspecialty consultative programme and new Inpatient eConsult Programme

Traditional in-person consultInpatient eConsult
Patient’s role in consultative service requestOrdered at discretion of primary team in discussion with patientOrdered at discretion of primary team in discussion with patient
Documentation that patient is aware that eConsult is being requested
Consultative service requestElectronic specialty consult order
(±verbal communication with consulting physician)
Electronic specialty eConsult order (±verbal communication with consulting physician)
Direct patient carePatient interview and examinationNone
Information sourcePatient, EHR, primary teamEHR and primary team
PPE and equipment useYesNo
Time to performLongerShorter
Physician locationOn siteRemote or on-site
Response timeWithin 24 hoursWithin 24 hours but usually shorter, after hours responses
Documentation requirementsChief complaint, history, review of systems, exam and medical decision making based on level of evaluation and management service providedConsultant’s opinion and time spent
Billing CPT codes99 251-9925599451—written communication
99 446-99449—written and verbal communication with primary team
Reimbursement limitationsNoneNot reimbursed if inpatient evaluation is required within 14 days
  • CPT, Current Procedural Terminology codes are used to identify medical services and procedures furnished by qualified healthcare professionals; EHR, electronic health record; PPE, personal protective equipment.