E-consults offer a digital platform where primary care physicians (PCPs) can consult specialists and obtain feedback or offer a direct specialty referral to their patients. The goal of this work is to investigate whether e-consults can advance the primary-specialty care interface and reduce referral delays. We provide a high-level abstraction of e-consult operations using an analytical framework that quantifies the benefit of e-consults in the context of efficient matching in a flexible service system. With heterogeneous patients who lack information regarding the severity of their condition, e-consults are conceptualized as Bayesian learning to estimate the true severity, parameterized by the level of e-consult efficacy, a measure of the degree of PCPs and specialists’ communication and information sharing efforts. The analytical framework of games with incomplete information combines the Hotelling model, the Bayesian inference, and service science to fully capture the patient flow dynamics between the PCP and the specialist modulated by the revelation of hidden patient severity information enabled by e-consults. The fundamental e-consult economics is related to strategic patients who are oversensitive toward the service prices and congestion costs, which leads to the overuse of one type of service. Such a behavior can be mitigated by e-consults that facilitate shared diagnostic efforts that can navigate patients away from the more popular choice toward a more suitable one. Note to Practitioners —An e-consult is a type of consultative service offered on a digital platform where primary care physicians (PCPs) can seek advice from specialists about patient referral recommendations. We aim to investigate the impact of e-consult service design on patient diversion, congestion, and social welfare. Our work exerts an exploratory effort to estimate the value of e-consults by providing a game-theoretic framework that measures the value added by information exchange in the context of a congested flexible service system. Our model sheds light on the value of e-consults in navigating a heterogeneous patient population to the best mode of treatment.

中文翻译：

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初级专科护理转诊中电子咨询的建模和分析

电子咨询提供了一个数字平台，初级保健医生（PCP）可以在该平台上咨询专家并获得反馈，或者直接向其患者转诊。这项工作的目的是调查电子咨询是否可以促进初级专科护理界面和减少转诊延迟。我们使用分析框架来提供电子咨询操作的高级抽象，该分析框架在灵活的服务系统中高效匹配的情况下量化了电子咨询的收益。对于缺乏有关病情严重程度信息的异类患者，将电子咨询概念化为贝叶斯学习，以估计真实的严重性，并通过电子咨询功效水平，PCP程度以及专家的沟通和信息来衡量参数分享努力。信息不完整的游戏的分析框架结合了Hotelling模型，贝叶斯推理和服务科学，以完全捕获PCP和专家之间的患者流动态，这些动态是通过电子咨询启用的隐藏患者严重性信息的揭示而调节的。电子咨询经济学的基本原理与战略患者有关，他们对服务价格和拥堵成本过于敏感，从而导致过度使用一种服务。可以通过电子咨询来缓解这种行为，该咨询有助于开展共享的诊断工作，从而可以使患者从更受欢迎的选择转向更合适的选择。和服务科学，以完全捕获PCP和专家之间的患者动态，这些动态是通过电子咨询启用的隐藏患者严重性信息的发现而调节的。电子咨询经济学的基本原理与战略患者有关，他们对服务价格和拥堵成本过于敏感，从而导致过度使用一种服务。可以通过电子咨询来缓解这种行为，电子咨询可以促进共享的诊断工作，从而使患者从更流行的选择转向更合适的选择。和服务科学，以完全捕获PCP和专家之间的患者动态，这些动态是通过电子咨询启用的隐藏患者严重性信息的发现而调节的。电子咨询经济学的基本原理与战略患者有关，他们对服务价格和拥堵成本过于敏感，从而导致过度使用一种服务。可以通过电子咨询来缓解这种行为，电子咨询可以促进共享的诊断工作，从而使患者从更流行的选择转向更合适的选择。执业者注意 —电子咨询是一种在数字平台上提供的咨询服务，初级保健医生（PCP）可以在该数字平台上就患者转诊建议向专家寻求建议。我们旨在调查电子咨询服务设计对患者转移，交通拥挤和社会福利的影响。我们的工作通过提供一个博弈论框架来评估电子咨询的价值，该博弈论的框架可以衡量在拥挤的灵活服务系统的情况下信息交换所带来的价值。我们的模型揭示了电子咨询在使异类患者群体进入最佳治疗方式方面的价值。