This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
Abstract
Objective The demand for neurology services at Geisinger exceeds the current clinical capacity. Therefore, we implemented and assessed the utility of Ask-a-Doc (AAD), which is an electronic medical record–based interface developed at Geisinger to facilitate communication between primary care physicians (PCPs) and specialists.
Methods AAD was used at the end of 2015 in our department. Based on the clinical picture, the PCP assesses whether to send an urgent AAD question with a phone request or a more elective question that can be answered by email message. The AAD message is then relayed to the on-call neurologist. We analyzed 4-year longitudinal data to assess for the efficacy of this tool in our department in improving patient care and communication.
Results There were a total of 3,190 messages during this period. Of which, 2,927 (91.7%) were completed and routed correctly, and 263 (8.3%) messages had errors including routing issues, communication mismatch, and delayed time frame. The average specialist turnaround time was 5 hours. During this period, the number of AAD messages increased by 300% as PCPs and neurologists became more comfortable with the process.
Conclusions AAD provides an interface between PCPs and neurology specialists and can assist in determining whether a patient needs to be seen urgently in the clinic, the correct subspecialty, and prerequisite diagnostic tests. AAD was successfully implemented and used in our rural neurology setting, with rapid turnaround, increased usage, and accuracy.
Footnotes
Funding information and disclosures are provided at the end of the article. Full disclosure form information provided by the authors is available with the full text of this article at Neurology.org/cp.
- Received June 1, 2020.
- Accepted September 22, 2020.
- © 2021 American Academy of Neurology
AAN Members
We have changed the login procedure to improve access between AAN.com and the Neurology journals. If you are experiencing issues, please log out of AAN.com and clear history and cookies. (For instructions by browser, please click the instruction pages below). After clearing, choose preferred Journal and select login for AAN Members. You will be redirected to a login page where you can log in with your AAN ID number and password. When you are returned to the Journal, your name should appear at the top right of the page.
AAN Non-Member Subscribers
Purchase access
The Nerve!: Rapid online correspondence
REQUIREMENTS
You must ensure that your Disclosures have been updated within the previous six months. Please go to our Submission Site to add or update your Disclosure information.
Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.
If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.
Submission specifications:
- Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
- Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
- Submit only on articles published within 6 months of issue date.
- Do not be redundant. Read any comments already posted on the article prior to submission.
- Submitted comments are subject to editing and editor review prior to posting.
