eConsults for Lab Results Interpretation and Imaging Review

As of 2023, many chronic illnesses reached unprecedented levels, including diabetes, arthritis, thyroid disorders, and cardiovascular diseases. Primary care teams are encountering an increasing volume of patients requiring more complex care. To meet their needs, consider introducing access to eConsults. One fundamental aspect of care that can particularly benefit from the assistance of a virtual specialist, via an eConsult is lab results interpretation and imaging review. When interpreting complex results, where uncertainty can impact patient outcomes, eConsults bridge the gap between primary care and specialized medicine.  Rapid access to virtual, board-certified specialists provides a streamlined approach to obtaining an expert opinion on your patient’s case. 

9 examples of how primary care clinicians use eConsults for imaging or lab results interpretation:

Cardiac Imaging: Interpreting an echocardiogram, MRI or CT of the heart and blood vessels; especially when evaluating complex valvular heart disease, heart muscle disorders (cardiomyopathies), or congenital heart disease can be challenging.  The support of a virtual cardiologist and radiologist can ensure the PCP is taking appropriate next steps for the patient.

Hemoglobin A1c (HbA1c): Though primary care clinicians frequently manage diabetic patients; borderline or unexpected HbA1c results may benefit from an endocrinologist’s input, especially with complex cases of multiple comorbidities or with uncertainty about the diagnosis.

Thyroid Function Tests (TFTs): Abnormal TFTs can indicate hypothyroidism or hyperthyroidism;  endocrinologists can guide further testing and management in cases of subclinical disorders or when the patient has comorbidities.

Rheumatologic Markers: A rheumatologist can help interpret these markers that may indicate autoimmune conditions in the context of the patient’s broader clinical picture, advising on additional diagnostics or therapeutic interventions.

Cardiac Enzymes: When myocardial infarction or other cardiac conditions are suspected, a consulting cardiologist can help interpret the significance of elevated cardiac enzymes, guiding further testing and management.

Liver Function Tests (LFTs): Abnormal LFTs can have a wide differential diagnosis. A gastroenterologist can provide insights into whether further imaging, liver biopsy, or specific markers are needed to diagnose conditions like non-alcoholic fatty liver disease, hepatitis, or cirrhosis.

Head & Neck Imaging (ENT): Findings on imaging such as CT scans or MRIs of the head and neck region that reveal sinus anomalies, masses, or structural irregularities indicating more complex pathologies may require collaboration between primary care physicians and ENT specialists.  This can help achieve an accurate diagnosis and optimal management of the patient’s condition.

Ortho Imaging: An orthopedic specialist can help answer questions that may arise from a review of  X-rays, MRI, or CT scans.  When images reveal bone abnormalities, complex fractures, signs of advanced osteoarthritis, or ambiguous masses, an orthopedic specialist’s expertise can help determine the most appropriate management plan. 

Urinalysis & Imaging: When a patient has elevated serum creatinine or abnormalities in urine analysis, along with structural abnormalities shown on ultrasound or CT scan, a nephrologist can help interpret these findings and guide early management of the underlying renal condition.

Tips for Submitting an eConsult for Lab Results Interpretation

To help the specialist understand the patient’s case and tailor their recommendations:

Be Specific: Outline a primary question or two related to the lab or imaging results. 

Provide Context: Include relevant patient history, symptoms, and any prior interventions. 

Summarize Previous Findings: If the patient has undergone related tests or treatments, summarizing these can prevent redundant recommendations.

Follow-up: If you have additional questions upon review of the specialist recommendation, ask a follow-up question! 

With rapid access to specialist input on a patient’s labs or images, primary care clinicians can remove uncertainties, streamline care, and improve patient outcomes and experiences. This collaborative approach not only enhances the quality of care, it also supports a learning environment where primary care clinicians can expand their expertise in managing complex cases.  Incorporating eConsults may require an adjustment in workflow and mindset, but the benefits are clear. By leveraging the expertise of specialists, primary care teams can make more informed decisions, reduce unnecessary referrals, and ultimately, deliver higher-quality, patient-centered care.