Comparison of traditional in-person subspecialty consultative programme and new Inpatient eConsult Programme
Traditional in-person consult | Inpatient eConsult | |
Requester | ||
Patient’s role in consultative service request | Ordered at discretion of primary team in discussion with patient | Ordered at discretion of primary team in discussion with patient Documentation that patient is aware that eConsult is being requested |
Consultative service request | Electronic specialty consult order (±verbal communication with consulting physician) | Electronic specialty eConsult order (±verbal communication with consulting physician) |
Responder | ||
Direct patient care | Patient interview and examination | None |
Information source | Patient, EHR, primary team | EHR and primary team |
PPE and equipment use | Yes | No |
Time to perform | Longer | Shorter |
Physician location | On site | Remote or on-site |
Response time | Within 24 hours | Within 24 hours but usually shorter, after hours responses |
Documentation requirements | Chief complaint, history, review of systems, exam and medical decision making based on level of evaluation and management service provided | Consultant’s opinion and time spent |
Billing CPT codes | 99 251-99255 | 99451—written communication 99 446-99449—written and verbal communication with primary team |
Reimbursement limitations | None | Not 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.