Effects of electronic psychiatric consultations on primary care provider perceptions of mental health care: Survey results from a randomized evaluation.
BACKGROUND
Primary care is the main point-of-entry for identifying and treating mental health problems. This research examines the effect of a new model of supporting primary care providers (PCPs) treating mental health disorders, the electronic consultation (eConsults), a standard process for communication between PCPs and psychiatrists through an electronic health records system.


METHODS
A cluster-randomized evaluation of the psychiatric eConsults model, as implemented in a large integrated delivery system. Web survey data before and after the implementation of psychiatric eConsults were collected on PCPs' perceptions of their capability and skill to deliver mental health services, and analyzed with linear regression models.


RESULTS
At baseline PCPs had mixed assessments of perceived support for delivering mental health services and of the availability of specialist consultations, but had relatively high perceived self-efficacy and skill for identifying, diagnosing and treating depression. PCPs in the Treatment group had statistically significant 18%, 13%, and 16% improvements in perceived support for diagnosing mental health problems, making treatment decisions, and changing treatment regimens, respectively; and 24% improved perceived ease of access to consultations for mental health, compared to the Control group. Evidence of effects on self-efficacy and perceived skill around depression was more limited.


CONCLUSIONS
The psychiatric eConsults model improved PCPs' perceptions of support for delivering mental health care and perceptions of access to specialist consultations.


CONCLUSIONS
Electronic consultations may be a promising approach to support the delivery of mental health services in primary care settings.


METHODS
Pre- and post-intervention web surveys from a cluster-randomized trial.
Division of Health Policy & Management, University of Minnesota School of Public Health, 420 Delaware St. SE, MMC 729, Minneapolis, MN 55455, United States. Electronic address: egolber@umn.edu.
Ezra
E
Golberstein
School of Psychology, University of Surrey, United Kingdom.
Sarah
S
Kolvenbach
Allina Health, Minneapolis, MN, United States.
Hilary
H
Carruthers
Department of Health Policy & Management, Rollins School of Public Health, Emory University, Atlanta, GA, United States.
Benjamin
B
Druss
Allina Health, Minneapolis, MN, United States.
Paul
P
Goering
D000328:Adult; D019033:Delivery of Health Care, Integrated / Q000379:methods / Q000592:standards; D005260:Female; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D008297:Male; D008605:Mental Health Services; D008875:Middle Aged; D010465:Perception; D011320:Primary Health Care / Q000379:methods* / Q000592:standards; D011795:Surveys and Questionnaires; D017216:Telemedicine / Q000379:methods*; D014481:United States; D000078329:Workforce