Dermatology Electronic Consults Versus In‐Person Consults: A Comparative Analysis in a Pediatric Emergency Department

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BACKGROUND: Limited research exists on the performance of dermatology electronic consults (eConsults) in pediatric emergency departments (PEDs). OBJECTIVE: To compare dermatology eConsults and in-person consults from a PED based on (1) note completion time and (2) diagnostic concordance with in-person dermatology evaluations. METHODS: We conducted a retrospective analysis of dermatology consults in a children's hospital PED between February 2020 and June 2024. Time elapsed between consult request and note completion was compared for eConsults versus in-person consults using t-tests. We assessed diagnostic concordance between initial consult and follow-up in-person dermatology evaluation using chi-square analysis. RESULTS: A total of 1118 consults were included (315 eConsults, 803 in-person consults), with 514 cases (135 eConsults, 379 in-person) having follow-up in-person dermatology evaluations. eConsults had a significantly faster mean time to note completion (1.94 vs. 4.70 h, p < 0.001). Diagnostic concordance rates did not significantly differ for full (77.0% vs. 73.9%), partial (20.0% vs. 23.2%), and non-concordance (3.0% vs. 2.9%) between eConsults and in-person consults, respectively (p = 0.75). LIMITATIONS: Retrospective nature and single-institution dataset. CONCLUSION: As implemented in our PED, pediatric dermatology eConsults were faster than, and as diagnostically concordant as, in-person consults.

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