Targeted automatic e-consultation (TACo) is a model of proactive e-consultation based on the automated identification of high-risk patients from electronic health records (EHR). TACos are triggered by patients’ EHR data rather than a consultation request. Through this model, specialist guidance could be offered to patients to improve workup and management.
In a study in the Journal of General Internal Medicine, Dr. Sri Lekha Tummalapalli, assistant professor of population health sciences and medicine, and colleagues evaluated the feasibility and acceptability of nephrologist TACos for hospitalized patients with hyponatremia in a pilot randomized trial. Hyponatremia is the most common electrolyte abnormality in hospitalized patients and is associated with adverse outcomes. They further assessed the resolution of hyponatremia by discharge among patients receiving TACos and those receiving usual care. Researchers conducted the study at the University of California San Francisco Health.
Results indicate that inpatient TACos for hyponatremia are feasible and acceptable for primary physician teams. Clinicians who received the TACo intervention reported that nephrologist recommendations frequently led to changes in diagnosis and management.
“By providing proactive as opposed to reactive consults through the TACo model, the efficiency and effectiveness of specialist consultations could be improved,” said Dr. Tummalapalli. These results call for larger-scale randomized trials which could evaluate the impact of the TACo model on clinical outcomes.
- Highlights