Abstract
The United States Department of Veterans Affairs (VA) created an electronic consult to increase access to specialty care. This system has the potential to improve access, reduce the number of face-to-face appointments, reduce travel and decrease chronic disease expense. Evaluation of the process is occurring at the same time as implementation. The purpose of this research was to perform a systems and human factors engineering analysis of the e-consult system. Using a mixed method approach we decomposed the e-consult process by analyzing the e-consults and interviewed system users. The e-consult program supports diabetes treatment but the system requires improvement. We describe seven areas of focus for system improvement. The recommendations provided serve as a requirements framework for electronic health record system upgrades.
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