Integrating AI and Telehealth: eConsults

eConsults have been critical for expanding timely access to specialty care, particularly in regions with limited access to specialist workforce, by enabling asynchronous, provider-to-provider consultation without requiring immediate face-to-face specialist visits. eConsults have been shown to reduce unnecessary specialty referrals, especially for lower-complexity clinical questions, reserving in-person specialty time for patients who need it most.While adoption of eConsults has increased since coverage and payment became permissible under Medicare in 2019 and under Medicaid and the Children’s Health Insurance Program (CHIP) in 2023, scalability remains constrained by a combination of workflow burden and billing constraints.

Artificial intelligence (AI) offers practical opportunities to support greater provider uptake of eConsults and expand access to specialty expertise by streamlining workflows and reducing administrative burden. With coordinated strategy, policy, and research, AI can help scale eConsult programs and advance more timely, efficient access to specialty care.

This was developed by Manatt Health and the Telehealth Centers of Excellence at the Medical University of South Carolina (MUSC) and the University of Mississippi Medical Center (UMMC) as part of a collaboration to identify and describe opportunities to integrate Artificial Intelligence (AI) within telehealth programs to support broader telehealth scaling and adoption. This brief is part of a series of four briefs, each focused on a different telehealth use case and based on background research and expert interviews with health system and telehealth vendor leaders.

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Association of American Medical Colleges. eConsult Payment Policy.

Hofman, Justin, et al. “Speed, Spectrum, and Satisfaction: Assessment of an Infectious Diseases eConsult Program.” Open Forum Infectious Diseases, May 2024.

Centers for Medicare & Medicaid Services. Coverage and Payment of Interprofessional Consultation in Medicaid and the Children’s Health Insurance Program (CHIP).