E-Consults as a Formalized Solution to the Hidden Workload of Curbsides

Conclusions

• Curbside consultations are common but create substantial hidden, uncompensated work with inconsistent quality, documentation gaps, and liability concerns, making them unsustainable as an informal model of care.
• eConsults formalize specialist input into a structured, documented workflow that improves communication, clarifies responsibility, and better protects both patients and consultants.
• The evidence presented suggests that patients, referring clinicians, and families generally value eConsults and are satisfied with the care they receive through them.
• Most dermatology eConsults can be managed without an in-person visit, indicating that the model can resolve many cases at the primary care level.
• When in-person evaluation is needed, eConsults improve triage by identifying urgent cases faster and shortening time to specialist appointment.
• eConsults can reduce wait times and cancellations for patients who do need specialty care, improving access efficiency.
• The program does not appear to reduce overall traditional referral volume, so eConsults may add capacity and triage value without simply replacing existing referrals.
• Successful implementation requires leadership support, clinical champions, IT/data infrastructure, and an intentional compensation model that recognizes eConsult work.
• A sustainable eConsult service can be built around wRVU credit, institutional incentives, residency supervision, or a dedicated virtualist model.
• Overall, the presentation concludes that eConsults are a practical, evidence-supported way to improve dermatologic access and should be adopted more broadly.