Multispecialty Telephone and E-mail Consultation for Patients with Developmental Disabilities in Rural California.

The University of California (UC), Davis Health System, and California Department of DevelopmentalServices (CDDS) developed the Physician Assistance, Consultation and TrainingNetwork (PACT Net) to assist primary-care providers (PCPs) care for patients with developmentaldisabilities in rural California. This manuscript describes PACT Net, a warmline using phone and e-mail, and its multispecialty panel. A pilot study evaluated whetheror not PCPs needed such a consultation service, whether or not it assisted them in providingcare, and their overall satisfaction with the service. PCPs were informed on how to request aconsultation. Data were collected from patients (demographics), PCPs (satisfaction with preexistingconsultation availability and quality, PACT Net consultation reason, preferred modeof contact, duration, and, satisfaction), and specialists (ease, quality of request, and satisfaction).Satisfaction was measured prospectively using a 7-point Likert scale. Data were collectedon 30 consultations, 28 by telephone and 2 by e-mail; other data were by combinedmethods. The average duration of consultation was 47 minutes, and 24 responses occurredwithin one business day. The top three services requested for consultation were psychiatry(e.g., management of behavioral disturbance), medical genetics (diagnosis), and gastroenterology(miscellaneous). PCPs rated baseline satisfaction with: (1) pre-existing local servicesat 3.37, (2) timeliness of the PACT Net consultation at 5.45, (3) quality of the communicationat 6.3, and (4) overall quality and utility of the consultation at 6.2. Specialists rated the qualityof the communication at 6.45, and the ease of the service at 6.46. Phone and e-mail consultationappears satisfactory to PCPs and specialty providers as a way to enhance specialtyinput to rural patients. [ABSTRACT FROM AUTHOR]