Dermatology has graciously agreed to prioritize e-consults from the ED/AUC. These consults are not in-person nor tele-health. Derm will review the information and photos you provide and give recommendations in the patient’s chart. E-consults can be obtained on all ED patients, including pediatrics.

If you are concerned for a life-threatening rash, please admit to Medicine as we have in the past (with Derm following). For example, you need an emergent consult to decide if an immunocompromised patient needs to be admitted for IV antibiotics/antivirals or transferred to a burn center, please ALSO PAGE the resident on-call who with help with management decisions. Again, this is not in-person.

Please limit consultations to extremely urgent issues (eg avoid "second opinion" or patient convenience consults). Derm faculty are stretched right now.

PHOTOS ARE MANDATORY. Please take both close up scale photos (rulers are in the nurse servers) and photos that show the overall distribution. Only do this through Haiku, please do not use any personal photo storage.

Derm will try to prioritize these consults during business hours into the early evening for turn around within a few hours. If the patient is stable and does not require admission, you can discharge the patient and await Derm’s recommendations as an outpatient. The ED Communication Center can help with follow up, send them a note and ask them to follow up on recommendations. The process to route a note to the ED Comm Center is in the red binders. You can also use the epic "bell" alarm to ensure the consult gets sent directly to your inbox. Make sure you have a contact number and pharmacy for the patient so you can inform them of any recommended prescriptions or follow up arrangements.

Derm is willing to work to get ED patients into their clinic for follow up at Meridian Clinic as needed (okay to take IEHP and medi-cal etc patients there). You can give that follow up information on the discharge paperwork.

Please let Emily Barrett ecbarrett@llu.edu know about any issues or concerns.

Dermatology E-Consult Order

· Title: AMB E-CONSULT TO DERMATOLOGY

· Type: E-Consult

Process Instructions

Before proceeding, inform patient of reason for requesting consultation. Ensure the patient has verbally consented to the requested consultation and process before submitting the E-Consult order.

Please ensure that an image is linked to the encounter or in your progress note. Additionally, if there are biopsy results please ensure that they are already scanned and available in the patient’s chart.

1. Type of E-Consult:* Button

1. Emergency Room

2. Ambulatory

2. Dermatologic Issues?* Select all that apply (button and text box)

1. Rash

2. Psoriasis

3. Eczema

4. Lesion

5. Skin Cancer

6. Blistering Disease

7. Acne

8. Other (free text)

3. Please upload relevant images for E-Consult request:

4. Previous treatment and response to treatment?* Text box

5. Current Treatment?* Text box

6. Location affected?* Select all that apply (button and text box)

1. Scalp

2. Face

3. Ears

4. Lips

5. Back

6. Chest

7. Abdomen

8. Upper extremities

9. Lower extremities

10. Buttocks

11. Perineum/genital skin

12. Other (free text)

7. What is the suspected diagnosis? * Text box

8. Question for Dermatology E-Consult? * Text box

9. Comment:* Text box