A qualitative investigation of uninsured patient and primary care provider perspectives on specialty care eConsults.

Background: Uninsured and underinsured patients face specialty care access disparities that prevent them from obtaining the care they need and negatively impact their health and well-being. We aimed to understand how making specialty care electronic consultations (eConsults) available at a multi-site Federally Qualified Health Center (FQHC) in central Texas affected uninsured patients' care-seeking experiences and impacted their ability to receive the needed care.

Methods: We used concepts from Ecological Systems Theory to examine individual, interpersonal, organization-level, social, and health policy environment factors that impacted patients' access to specialty care and the use of eConsults.

Impact of eConsults on Clinical Care in Primary Care: A Cross-Sectional Analysis of Primary Care Provider Behavior.

Introduction/objectives: Asynchronous electronic consultations (eConsults) support primary care providers (PCPs) by providing rapid specialist feedback and improve medically underserved patients' access to care.

Methods: This cross-sectional study assessed all eConsults requested over a one-year period at a multi-site federally qualified health center in Texas. We analyzed eConsult content and quality and conducted chart reviews for a randomly selected subsample (n = 100) to determine whether PCPs implemented specialists' recommendations within 90 days.

Increased Revenue From Averted Missed Appointments Following Telemedicine Adoption at a Large Federally Qualified Health Center.

This study examined savings from averted missed appointments following telemedicine adoption. Data were obtained from a large Federally Qualified Health Center in Texas during the early pandemic months. Patient encounters fell into one of three categories: (1) in-person visit, (2) telemedicine alone with no support team engagement, and (3) telemedicine with previsit support team engagement for device and connectivity testing.

Associations between Patient- and Provider Level Factors, and Telemedicine Use in Family Medicine Clinics.

Introduction: Increased telemedicine implementation may promote primary care access. However, gaps in telemedicine uptake may perpetuate existing disparities in primary care access. This study assessed provider- and patient-level factors associated with telemedicine use in community-based family practice clinics.

The Impact of eConsults on Access to Specialty Care for the Uninsured in Rural Texas.

Objective: This study evaluated the impact of eConsults on access to specialty care for uninsured patients in Central Texas.

Methods: eConsults for four specialties, cardiology, gastroenterology, rheumatology, and endocrinology, were implemented in a large, multi-site federally qualified health center. Data were collected on specialty care access and utilization for a one-year period before and after implementation of the new process.

Utilization Gaps During the COVID-19 Pandemic: Racial and Ethnic Disparities in Telemedicine Uptake in Federally Qualified Health Center Clinics.

Background: The Coronavirus Aid, Relief, and Economic Security (CARES) Act led to the rapid implementation of telemedicine across healthcare office settings. This innovation has the potential to improve healthcare use and ensure continuity of care. However, this delivery model could have an unintended consequence of worsening racial/ethnic disparities in healthcare utilization if adoption varies across sub-populations.

Transition to telemedicine and its impact on missed appointments in community-based clinics.

Background And Objective: The Coronavirus Aid, Relief, and Economic Security Act led to the rapid implementation of telemedicine across health care office settings. Whether this transition to telemedicine has any impact on missed appointments is yet to be determined. This study examined the relationship between telemedicine usage and missed appointments during the COVID-19 pandemic.