The impact of hematology electronic consultations on the management of iron deficiency

Eur J Haematol. 2024 Nov;113(5):614-622. doi: 10.1111/ejh.14276. Epub 2024 Jul 12.

Abstract

Objectives: Delays in the evaluation and treatment of iron deficiency can lead to increased disease-related morbidity and mortality. Electronic consultation (e-consult) is a referral modality that allows providers quicker access to recommendations from a specialist based on electronic chart review. While the use of e-consult is expanding in classical hematology, gaps exist in the understanding of patient outcomes related to its use for iron deficiency.

Methods: We randomly selected 200 e-consults and 200 traditional referrals from 3,336 hematology referrals for iron deficiency at a single center. The primary outcomes of the retrospective analysis were: time to completion of the referral, and time to treatment with intravenous iron. Secondary outcomes included recurrence of iron deficiency, need for repeat e-consult, conversion to in-person evaluation, and assessment of whether the etiology of iron deficiency was addressed.

Results: E-consults significantly reduced the time from referral to intravenous iron repletion (e-consult, 33 days; traditional referral, 68 days; p < .05). Assessment of the underlying etiology occurred in 70.7% of the e-consult encounters compared to 92.5% of traditional referrals (p < .05).

Conclusions: These findings highlight advantages of e-consults in improving care delivery in iron deficiency, and identifying gaps that can be improved through practice standardization to ensure equitable, high-value care.

Keywords: electronic consultation; iron‐deficiency; remote consultation; telemedicine.

MeSH terms

  • Adult
  • Aged
  • Anemia, Iron-Deficiency* / diagnosis
  • Anemia, Iron-Deficiency* / epidemiology
  • Anemia, Iron-Deficiency* / etiology
  • Anemia, Iron-Deficiency* / therapy
  • Disease Management
  • Female
  • Hematology / methods
  • Hematology / standards
  • Humans
  • Iron / administration & dosage
  • Male
  • Middle Aged
  • Referral and Consultation*
  • Retrospective Studies

Substances

  • Iron