• Leah Zallman, Carolyn F Fisher, Sofia Ladner, Kira Mengistu, Alison B Rapaport, David Bor, Zhiheng He, Joel Sawady, Robert Stavert, Rachel Nardin, Adarsha Bajracharya, Richard Pels, and Assaad Sayah.
• Cambridge Health Alliance, Cambridge, MA, USA.
• Fam Pract. 2020 Sep 5; 37 (4): 525-529.

BackgroundInter-clinician electronic consultation (eConsult) programmes are becoming more widespread in the USA as health care systems seek innovative ways of improving specialty access. Existing studies examine models with programmatic incentives or requirements for primary care providers (PCPs) to participate.ObjectiveWe aimed to examine PCP perspectives on eConsults in a system with no programmatic incentive or requirement for PCPs to use eConsults.MethodsWe conducted seven focus groups with 41 PCPs at a safety-net community teaching health care system in Eastern Massachusetts, USA.ResultsFocus groups revealed that eConsults improved PCP experience by enabling patient-centred care and enhanced PCP education. However, increased workload and variations in communication patterns added challenges for PCPs. Patients were perceived as receiving timelier and more convenient care. Timelier care combined with direct documentation in the patient record was perceived as improving patient safety. Although cost implications were less clear, PCPs perceived costs as being lowered through fewer unnecessary visits and laboratories.ConclusionsOur findings suggest that eConsult systems with no programmatic incentives or requirements for PCPs have the potential to improve care.© The Author(s) 2020. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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