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Seven Insights: Implementing a Clinical Electronic Consultation “eConsult” Platform

By Shani S. Trudgian Sari Weis Shellown Persaud Category Healthcare High-Tech
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Nationwide, safety net healthcare delivery systems are adopting and optimizing electronic consultation “eConsult” technology, facilitating patient-specific clinical dialog between primary care and specialty providers on a shared platform. What systemic problems are being resolved by this technology? What improvements to access, patient and provider experience and the bottom line are being achieved? What new opportunities does an eConsult platform offer? Our seven insights, grounded in hands-on experience with eConsult vendors and stakeholders address the adoption of eConsult within the safety net delivery systems.

Metrics are Key.

Delivery systems invest in an eConsult platform to reduce unnecessary specialty appointments, provide communication exchange with primary care physicians and specialists, facilitate a better care experience for patients, and improve patients’ clinical outcomes. Establishing a dashboard comparing baseline data with outcomes enables the delivery system to measure the operational and clinical impact, calculate financial benefits, and trend optimization efforts over time.

Meaningful Provider Engagement is the Backbone.

Identify and engage a clinician-based core team at the beginning of the eConsult implementation and seek consensus on the need (problems being solved), value (benefits to the delivery system stakeholders) and effort (team commitment). Ensure the clinicians contribute to each phase: requirements gathering, vendor selection, testing, training, implementation and optimization.

Executive Champions are the Drivers.

Executive champions from technology, operations and medical leadership areas must be in close alignment in the prioritization of the eConsult initiative relative to other change projects. Without this triad of affiliated executive champions, as well as full CEO support, the eConsult implementation will face significant challenges to achieve large-scale system, process and provider practice changes.

Early Protocols from End Users is Essential.

The expertise and feedback from the intended end users of the eConsult system is invaluable. It is critical to include not only providers, but frontline operations stakeholders (e.g., schedulers and referral coordinators) in the brainstorming and decision-making process beginning in the initial planning stages. Introducing, implementing and sustaining protocols require early contributions, buy-in and vocal support from end users.

Phasing the Rollout Increases Adoption.

It is important to explore whether it would be more beneficial to implement all specialties simultaneously, or to structure the rollout in phases. Our experience is that phasing a system rollout by implementing a few specialties in each phase provides the opportunity to identify, analyze and correct defects, as well as to optimize processes with minimal impact to patient access across all specialties.

Prioritizing Appointment Scheduling.

In some cases, an electronic consultation drives the need to schedule a specialty appointment. Scheduling can be centralized or decentralized, and can occur in a call center structure or at the specialty clinic level. Regardless of the decision, the scheduling process and how to prioritize appointments when access is limited should be clearly defined and will optimize the experience for both patients and specialty providers.

Rigorous Change Management Drives Viability.

Successfully implementing, operationalizing and optimizing eConsult technology involves a dedicated change management work stream rather than folding it into project management activities. Bringing all stakeholders through the stages of change, starting with awareness, shifting to understanding, moving to acceptance, then adoption and finally empowerment is essential for sustainable outcomes. Refer to our Seven Insights on Change Management.

About the Authors

Shellown Persaud, MHA: Shellown is a Senior Consultant in the Kenny & Company Healthcare Practice with 10 years of experience in the public, private and not-for-profit areas of the healthcare sector. She is a proactive and results-driven professional with experience in leading and working with teams, process improvement, system implementation, and managing small and large-scale projects and programs. Shellown is passionate about building and sharing knowledge, implementing change, and addressing systemic problems.

Shani Trudgian: Shani is the Healthcare Practice Partner and CXO at Kenny & Company with 25 years in management consulting and business development experience, focused exclusively in healthcare. She has guided her clients through health reform readiness strategy and implementation, process re-engineering, acquisitions, Accountable Care Organization implementation, ambulatory health care delivery refinement, business model analysis, change leadership and in other strategic areas. Shani’s industry experience includes medical groups/IPAs, county/private/teaching hospitals, health plans (public/private), health systems, safety net clinics, non-profit grant-making philanthropy, and behavioral health organizations.

Sari Weis, MPA: Sari is the Manager of the Kenny & Company Healthcare Practice with 14 years of experience in the public and not-for-profit areas of the healthcare sector. Sari is an effective manager of people, time and resources and has excellent problem solving and decision-making skills. She has experience establishing and maintaining strong effective partnerships. In addition, she has a passion for facilitation, building implementing quality improvement programs, and leading multi-disciplinary teams to identify and address organizational problems’ root causes.

About Kenny & Company

Kenny & Company is a management consulting firm offering Strategy, Operations and Technology services to our clients.

We exist because we love to do the work. After management consulting for 20+ years at some of the largest consulting companies globally, our partners realized that when it comes to consulting, bigger doesn’t always mean better. Instead, we’ve created a place where our ideas and opinions are grounded in experience, analysis and facts, leading to real problem solving and real solutions – a truly collaborative experience with our clients making their business our business.

We focus on getting the work done and prefer to let our work speak for itself. When we do speak, we don’t talk about ourselves, but rather about what we do for our clients. We’re proud of the strong character our entire team brings, the high intensity in which we thrive, and above all, doing great work.

This article was first published at on October 15, 2018. The views and opinions expressed in this article are provided by Kenny & Company to provide general business information on a particular topic and do not constitute professional advice with respect to your business.

Seven Insights: Implementing a Clinical Electronic Consultation “eConsult” Platform by Shellown Persaud, Shani Trudgian, and Sari Weis at Kenny & Company is licensed under a Creative Commons Attribution-NoDerivs 3.0 United States License . Kenny & Company has licensed this work under a Creative Commons Attribution-NoDerivs 3.0 United States License.