“I was also surprised by some of the reasons given why serologic and auto-antibody tests were checked in patients with non-specific joint pain, along with the number of times high-sensitivity C-reactive protein (CRP) was used rather than regular CRP in assessing systemic inflammation in rheumatic diseases,” she says.
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Beyond the findings of this investigation, Dr. Jain and her study co-authors have investigated eConsult data regarding differences in the need for future outpatient consultation between rheumatology and other medical subspecialties. They’ve also examined the development of tailored educational content for internal medicine residents and internal medicine physicians based on specific cases of eConsult communications.
So far, this investigation “highlights that, in rheumatology especially, the diagnosis and management of many of our diseases truly rest on a thorough history to look for subtle clues, as well as the physical exam with lab tests that often … help support our clinical suspicion of a disease process,” Dr. Jain says. “Although there is value in eConsults reducing the need for face-to-face consultation in certain specialties, for rheumatology the value of the eConsult rests on triaging urgent vs. routine outpatient visits, along with an educational role of enriching practice-based learning.”
Opportunities to Educate
This analysis of eConsult communications revealed common themes in both PCP questions and rheumatologist recommendations, underscoring areas for further education, according to Dr. Jain. She believes targeted education addressing such knowledge gaps may “be applied at the internal medicine resident level. [This level will] capture the highest yield [to address] the most common types of questions and eConsult questions asked of the rheumatology eConsultant.”
Carina Stanton is a freelance science journalist based in Denver.
- Jain R, Broder A, Rikin S, et al. Identifying educational themes and knowledge gaps through analysis of electronic consultation (eConsult) communication between primary care physicians and rheumatologists [abstract #1796]. Arthritis Rheumatol. 2019 Oct;71(suppl 10).