Electronic consultation and referral service is safe and reduces the need for tertiary evaluations for disorders of gut–brain interaction in children

Abstract Background Electronic consultation systems are increasingly used to improve access to specialists due to growing demand and prolonged wait times. Our Pediatric Gastroenterology Division in Edmonton launched an eReferral system in 2020, which allows healthcare providers to seek patient-related advice and directly refer to our subspecialty. Methods As a quality improvement project, we completed a retrospective chart review of paediatric gastroenterology eReferrals in Edmonton from 2022 to 2023. We aimed to understand patient outcomes, including emergency department visits, hospitalizations, and need for formal gastroenterology consultation and/or endoscopy. Results A total of 318 patients were referred through eReferral during the 2-year period. Most patients (263/318, 83%) were initially referred conventionally, via fax, or electronic medical record referral module, and were redirected by the triaging physician to seek eReferral advice. The remainder were self-initiated eReferral requests. In total, 11% (34/318) of eReferral patients visited the emergency department for the same gastroenterology concern after eReferral advice. Only 76/318(24%) of eReferral patients were seen by paediatric gastroenterology. About 26/76(34%) of these patients underwent endoscopy, and the majority of findings (21/26, 81%) were normal or non-specific without relevance to the patient’s symptoms or management. About 43/76(57%) of patients reviewed by gastroenterology were ultimately diagnosed with a disorder of gut–brain interaction (DGBI). Conclusions The eReferral system appears to be an effective tool in the management and care of paediatric patients with suspected DGBIs referred to our paediatric gastroenterology service. Most of these patients have disorders that do not require endoscopy or formal GI consultation. Timely e-advice to referring physicians can expedite enhanced care in the patient’s medical home.