The Virtual Consult

Abstract

In 2010, Group Health modified their EMR system to allow for “Virtual Consults,” which involve asynchronous communication between physicians, either between Primary Care and a Specialist, or between Specialists. The intended use is for medical questions about ongoing or new clinical concerns and for fully documenting care that does not require a face-to-face interaction between the patient and the consulted physician. The response to the initial consult request happens quickly (often within 1–2 h, but always within 24 h), is formally documented in the medical record, and is recognized by the corporate entity and incentivized. See Fig. 10.1 as an example of a virtual consult completed by Neurology for a headache patient. Figure 10.2 then shows the “dummy” level of service (LOS) assigned by the provider completing the consult, which allows for reporting and relative value unit (RVU) assignment for service compensation.