Date of Completion


Embargo Period



Dr. Joseph Burleson & Dr. Minakshi Tikoo

Field of Study

Public Health


Master of Public Health

Open Access

Open Access


Electronic consults (e-consults) are types of communications systems used between physicians and their patients to communicate outside the medical office. While nothing can replace the traditional face-to-face interaction, e-consults can be used to help manage patient queue, share non-urgent information, and provide an alternative avenue of communication while recording electronic copies. Literature reveals that lack of a standardized reimbursement system, uncertain workloads, and perceived risks to patient confidentiality are barriers to mainstream adoption of e-consult systems. The purpose of this study is to investigate the practice and patient characteristics of the use of e-consults between primary care physicians (PCP) and their patients using the 2010 National Ambulatory Medical Care Survey (NAMCS).

The analysis reveals that practicing in an HMO and having long patient wait times for an appointment for a routine medical exam are associated with PCP use of e-consults. Findings also indicate that the use of e-consults was associated with patients experiencing a new health problem that occurred within 3 months, and patients that have private insurance (P<0.05). These findings suggest that the infrastructure of the medical practice and patients’ needs are key drivers of whether a PCP uses e-consults in his or her practice. Primary care physicians who use e-consults spend an extra 1.6 minutes in face-to-face time with their patients (20.3 minutes vs. 18.7 minutes). However, further analysis indicates that it is inconclusive to determine whether the use of e-consults affects the amount of time spent the physician spends face-to-face with the patients.

Major Advisor

Dr. Jane Ungemack