Enhancing Pediatric Specialty Care Access Through E-Consults

The ongoing shortage of pediatric specialists across the nation has led to significant challenges in providing timely and effective care for young patients. Many children experience prolonged wait times—sometimes spanning weeks or even months—for specialist appointments. To address this critical issue, recent research published in Clinical Pediatrics highlights the positive impact of electronic consultations (e-consults) implemented at UC Davis Health.

E-consults are secure, asynchronous interactions integrated within the hospital's electronic health record (EHR) system. They enable primary care pediatricians to consult directly with specialists, discussing patient cases remotely. Once the specialist's recommendations are provided, the primary care doctor communicates the next steps to the patient's family. This approach aims to bridge the gap between primary and specialty care, reducing wait times and improving health outcomes.

Ulfat Shaikh, a professor of pediatrics and medical director of Healthcare Quality at UC Davis, emphasizes that the specialist shortage often causes delays and adversely affects children with complex or chronic conditions. E-consults help mitigate these challenges by allowing primary care providers to seek second opinions or specialist advice without the need for an in-person visit, which can be lengthy and resource-intensive.

The study involved a comprehensive effort to increase awareness and utilization of e-consults within UC Davis Health's pediatric clinics, which care for approximately 2,800 children annually. The team worked closely with various specialties to establish protocols, educate clinicians, and update the EHR referral system to promote the service. As a result, the rate of e-consult requests increased from 14% to 43%. During the study, 65 e-consults were conducted, primarily for issues such as skin eruptions, hemangiomas, alopecia, and seizures. Notably, patients experienced an average response time of just one day from specialists, a stark contrast to the 59 days typically required for in-person appointments.

Feedback from primary care pediatricians, specialists, and referral coordinators indicated that e-consults greatly benefited all parties. Families experienced less disruption—avoiding prolonged absences from work or school and reducing travel, especially in rural areas. Clinicians gained quicker access to expert advice, enabling more informed decision-making and faster diagnostics. Specialists could prepare better for in-person visits by ordering necessary tests through e-consults, leading to more effective and efficient care.

In summary, the integration of e-consults significantly enhances access to pediatric specialty care by reducing wait times, streamlining communication, and making healthcare delivery more timely and efficient. These findings support the broader adoption of digital consultation tools to improve pediatric healthcare outcomes, particularly in underserved and rural communities.

source: https://medicalxpress.com/news/2025-06-pediatric-access-specialty.html