{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,21]],"date-time":"2026-03-21T01:28:18Z","timestamp":1774056498075,"version":"3.50.1"},"reference-count":11,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2022,7,18]],"date-time":"2022-07-18T00:00:00Z","timestamp":1658102400000},"content-version":"vor","delay-in-days":17,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,7,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Safety net healthcare systems have high patient volumes and significant demands for specialty care including infectious diseases (ID) consultations. Electronic ID consults (E-consults) can lessen this burden by providing an alternative to face-to-face ID referrals and decreasing financial, time, and travel constraints on patients. This system could increase access to ID care for patients in limited-resource settings.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We described characteristics of all outpatient ID E-consults at Parkland Health in Dallas, Texas, from March 2018 to February 2021. We used modeling to determine which characteristics influenced conversion of E-consults to clinic visits and integrated these data into a predictive model for face-to-face conversion.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>For 725 E-consults, common E-consult topics included 118 (16%) latent tuberculosis, 116 (16%) syphilis, and 76 (10%) gastrointestinal infections. Nearly two-thirds of E-consults (456 [63%]) were requested by primary care providers. The majority (78%) were resolved without a face-to-face ID visit. Osteomyelitis, nontuberculous mycobacterial, and gastrointestinal questions frequently required face-to-face visits at rates of 65%, 49%, and 32%, respectively. Our logistic regression model predicted the need for a face-to-face visit with 80% accuracy and an area under the receiver operating characteristic curve of 0.72.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>An outpatient ID E-consult program at a safety net healthcare system was an effective tool to provide timely input on common ID topics. E-consults were requested by a range of providers, and most were completed without a face-to-face visit. Predictive modeling identified important characteristics of E-consults and predicted conversion to face-to-face visits with reasonable accuracy.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ofid\/ofac341","type":"journal-article","created":{"date-parts":[[2022,7,18]],"date-time":"2022-07-18T18:28:20Z","timestamp":1658168900000},"source":"Crossref","is-referenced-by-count":5,"title":["Implementation of Outpatient Infectious Diseases E-Consults at a Safety Net Healthcare System"],"prefix":"10.1093","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9814-8043","authenticated-orcid":false,"given":"Richard J","family":"Medford","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases and Geographic Medicine, Department of Medicine, University of Texas Southwestern Medical Center , Dallas, Texas , USA"},{"name":"Division of Infectious Diseases, Parkland Health and Hospital System , Dallas, Texas , USA"},{"name":"Clinical Informatics Center, University of Texas Southwestern Medical Center , Dallas, Texas , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6909-7774","authenticated-orcid":false,"given":"Madison","family":"Granger","sequence":"additional","affiliation":[{"name":"University of Texas Southwestern Medical School , Dallas, Texas , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Madison","family":"Pickering","sequence":"additional","affiliation":[{"name":"Clinical Informatics Center, University of Texas Southwestern Medical Center , Dallas, Texas , USA"},{"name":"Division of Physical Sciences, Department of Computer Science, University of Chicago , Chicago, Illinois , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9559-4646","authenticated-orcid":false,"given":"Christoph U","family":"Lehmann","sequence":"additional","affiliation":[{"name":"Clinical Informatics Center, University of Texas Southwestern Medical Center , Dallas, Texas , USA"},{"name":"Department of Pediatrics, University of Texas Southwestern Medical Center , Dallas, Texas , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Mayorga","sequence":"additional","affiliation":[{"name":"Division of Digestive and Liver Diseases, Parkland Health and Hospital System , Dallas, Texas , USA"},{"name":"Division of Digestive and Liver Diseases, Department of Medicine, University of Texas Southwestern Medical Center , Dallas, Texas , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helen","family":"King","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and Geographic Medicine, Department of Medicine, University of Texas Southwestern Medical Center , Dallas, Texas , USA"},{"name":"Division of Infectious Diseases, Parkland Health and Hospital System , Dallas, Texas , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2022,7,18]]},"reference":[{"key":"2022072610282510200_ofac341-B1","doi-asserted-by":"publisher","first-page":"ofaa101","DOI":"10.1093\/ofid\/ofaa101","article-title":"Electronic consults for infectious diseases in a United States multisite academic health system","volume":"7:","author":"Wood","year":"2020","journal-title":"Open Forum Infect Dis"},{"key":"2022072610282510200_ofac341-B2","doi-asserted-by":"publisher","first-page":"1123","DOI":"10.1093\/cid\/cix058","article-title":"Electronic consultations (e-consults): advancing infectious disease care in a large Veterans Affairs healthcare system","volume":"64","author":"Strymish","year":"2017","journal-title":"Clin Infect Dis"},{"key":"2022072610282510200_ofac341-B3","doi-asserted-by":"publisher","first-page":"e19203","DOI":"10.7759\/cureus.19203","article-title":"Characteristics and outcomes of infectious diseases electronic COVID-19 consultations at a multisite academic health system","volume":"13","author":"Yagnik","year":"2021","journal-title":"Cureus"},{"key":"2022072610282510200_ofac341-B4","doi-asserted-by":"publisher","first-page":"2031","DOI":"10.1377\/hlthaff.2018.05124","article-title":"Reduced cost of specialty care using electronic consultations for medicaid patients","volume":"37","author":"Anderson","year":"2018","journal-title":"Health Aff"},{"key":"2022072610282510200_ofac341-B5","doi-asserted-by":"publisher","first-page":"471","DOI":"10.1093\/jamia\/ocz185","article-title":"Electronic consultations (E-consults) and their outcomes: a systematic review","volume":"27","author":"Vimalananda","year":"2020","journal-title":"J Am Med Inform Assoc"},{"key":"2022072610282510200_ofac341-B6","doi-asserted-by":"publisher","first-page":"ofaa003","DOI":"10.1093\/ofid\/ofaa003","article-title":"Association of a remotely offered infectious diseases econsult service with improved clinical outcomes","volume":"7","author":"Tande","year":"2020","journal-title":"Open Forum Infect Dis"},{"key":"2022072610282510200_ofac341-B7","doi-asserted-by":"publisher","first-page":"821","DOI":"10.1055\/s-0040-1719181","article-title":"Electronic consultations (eConsults) for safe and equitable coordination of virtual outpatient specialty care","volume":"11","author":"Lee","year":"2020","journal-title":"Appl Clin Inform"},{"key":"2022072610282510200_ofac341-B8","first-page":"66","volume-title":"Parkland annual report 2020","author":"Parkland Health and Hospital System","year":"2020"},{"key":"2022072610282510200_ofac341-B9","first-page":"9","volume-title":"Dallas County community health needs assessment","author":"Parkland Health and Hospital System\/ Dallas County Health and Human Services","year":"2019"},{"key":"2022072610282510200_ofac341-B10","doi-asserted-by":"publisher","first-page":"492","DOI":"10.1377\/hlthaff.2016.1283","article-title":"Los Angeles safety-net program eConsult 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