SIMULATION TOOL TO EVALUATE ELECTRONIC CONSULTATIONS IN RHEUMATOLOGY

Complex patients, limited specialists, and high demand create long referral queues ill-equipped to deliver timely quality care. One approach to reduce queue length is for specialists to review referrals through an electronic consultation (e-consult) and determine if 1) the patient requires a specialty appointment or 2) the primary care physician can continue care with the specialist's recommendations. As inappropriate patients are removed from specialty queues, it is hypothesized that lead times will decrease and the system will be more efficient at delivering the right care to the right patient at the right time. A discrete-event simulation was built to estimate the impact e-consults have on Rheumatology clinics at Duke Health; specifically considering lead time, queue length, and specialists' workload. This is an adaptable tool with visualizations for which any specialty clinic, each with its own complex challenges, could estimate the impact e-consults have on delivering quality care to referred patients.