- The patient initiates communication-based on convenience 
- Patient can use self-service tools
- Live/autonomous responses can be employed
- Live text/messaging can be used for communication

University of California, Santa Cruz

Specialists can communicate in real-time to optimize patient care as well as having accessible second opinions based on patient request.

E-consult: clinician-to-clinician communications

- Opportunities of E-consult: clinician-to-clinician communications
- Opportunities for Remote patient monitoring
- Opportunities for Patient-initiated messaging
- Opportunities for Telephone visit
- Opportunities for Video visit

Opportunities of telehealth infrastructure

Kruse, C. S., Krowski, N., Rodriguez, B., Tran, L., Vela, J., & Brooks, M. (2017). Telehealth and patient satisfaction: A systematic review and narrative analysis. BMJ Open, 7(8). doi:10.1136/bmjopen-2017-016242

Telehealth and patient satisfaction: a systematic review and narrative analysis

Wosik, J., Fudim, M., Cameron, B., Gellad, Z. F., Cho, A., Phinney, D., . . . Tcheng, J. (2020). Telehealth transformation: COVID-19 and the rise of virtual care. Journal of the American Medical Informatics Association, 27(6), 957-962. doi:10.1093/jamia/ocaa067

Telehealth transformation: COVID-19 and the rise of virtual care

- It can shift extra work to front-line medical providers
- Lack of a direct physical exam on patients
- Communication is through a platform rather than being face-to-face

Limitations to clinician-to-clinician communications

- Time-efficient for specialists
- Patient-initiated second opinion requests are possible

Opportunities of E-consult: clinician-to-clinician communications

- Respond to clinical data outside of regular clinic visits
- Recordings can be automatically sent to clinicians

Opportunities for remote patient monitoring

- Telephone visits are basically universally accessible by today's standards of living

Opportunities for telephone visits

- Improvement on clinical care in comparison to telephone visits
- A variation of a physical exam can be made using peripheral devices 
- favorable for reimbursement by insurance

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