2026 Southeastern Residency Conference

Title:
Transforming Care: Assessing the Role and Impact of Clinical Pharmacist Practitioners through Electronic Consult Services

Authors:
McKinley Corley, Deborah Hobbs, Marci Swanson, Nieka Jackson

Background/Purpose:
The purpose of this project is to evaluate a correlation in e-consults completed by clinical pharmacist practitioners (CPPs) and the impact they have in enhancing Veteran care.

Electronic consults (E-Consults) have been widely used in healthcare systems. An e-consult is initiated by one healthcare provider seeking the opinion of a specialist pertaining to the question at hand. Benefits of e-consults include: engaging specialists earlier in the workup process to minimize unnecessary testing, providing more prompt input from specialists, ensuring more succinct chart documentation, and reducing the need for patient travel. Pharmacists can be one of the specialists that are sought out to respond to the e-consults. E-consults have demonstrated to be an effective method for providers to receive timely pharmacist recommendations. Pharmacists can improve patient outcomes via e-consults by preventing medication-related problems. Research shows that pharmacist recommendations made through e-consults have a positive impact on patient outcomes. The numerous studies conducted within the VA system demonstrate that the Department of Veterans Affairs is at the forefront of using e-consults to improve patient outcomes.

Methodology:
This performance improvement project was approved by the Carl Vinson VA Medical Center Pharmacy and Therapeutics Committee. This project aims to evaluate the implementation rate of clinical pharmacist recommendations and various aspects of the e-consult process. Primary and secondary objectives include characterizing the use and types of clinical pharmacist e-consults, evaluating completion timelines, and assessing the extent of patient management by CPP clinics resulting from e-consults. Data was collected through a retrospective chart review of e-consults using the Integrated Document Manager in VISTA. All clinical pharmacy e-consults completed between 10/01/2024 – 09/30/2025 were evaluated. Exclusion criteria included cancelled e-consults, BHIP Medication Management Consults, and Congestive Heart Failure Re-admission Consults. Collected data encompassed patient demographics (sex, age, race, location), consult details (title, category, requesting provider, and author), reason for e-consult, number of requests per e-consult, time required for completion, the number of accepted recommendations, and referrals to CPP. This comprehensive data collection aims to provide insights into the efficacy and efficiency of clinical pharmacist interventions via e-consults.

Results:
A total of 736 e-consults were completed, leading to 795 recommendations. Out of these recommendations, 688 (86.5%) were accepted by the providers, while 107 (13.5%) were not. The majority of the consults were related to pain management. Impressively, 93.8% of the consults were completed within 72 hours, meeting the established criteria. Additionally, approximately one-third of the patients were referred to CPP clinics as a direct result of the e-consult responses. Overall, this project was highly successful.

Conclusions:
The findings of this project align with published literature supporting pharmacist-led e-consult services. The high acceptance/implementation rate validates the role of the Clinical Pharmacist Practitioners in e-consult services. Opportunities exist to expand and optimize e-consult utilization across the facility, including filling in potential gaps of care and e-consult simplification.