Standard specialist referrals have a completion rate of less than 35% due to months-long appointment waitlists, frustrating administrative obstacles, and the significant financial strain on patients needing specialized care. These challenges are even greater for patients managing chronic conditions with multiple specialists that may offer conflicting medical advice. To streamline specialist recommendations, improve primary care physician's care plans, and alleviate the burden on patients, RubiconMD developed ProConsults. This platform proactively generates collaborative care recommendations for physician's patients based on their medical history and promotes alignment between consultants' recommendations.

I interviewed five RubiconMD specialists about their experience with writing ProConsult recommendations within the eConsult platform. They noted that the lengthy patient medical histories included in ProConsult submissions required twice as much time to review compared to standard eConsults and also expressed concern for the lack of visibility into the final synthesized recommendation. The large number of attachments needing to be managed in new tabs sometimes led to errors like referencing the wrong patient file while writing recommendations. To address these frustrations, we introduced an attachment viewer that opens in the same window as the response field and provided specialists with visibility into both their original responses and the final compiled recommendations.

Specialists also mentioned difficulties with "snippets," frequently used templates or phrases they created in-app to insert into their responses. On the eConsult platform, snippets were only searchable by easily forgotten titles, listed chronologically from oldest to newest, and included only a sentence long preview of the content. To improve the snippet experience for specialists, I enabled searching by both snippet title and content, sorted the list alphabetically, and provided a full snippet preview.

To understand the adoption rate of ProConsult recommendations into patients' care plans, I designed a simple "yes" or "no" rating system to gather feedback both in-app and in PDFs generated for off-platform use. Users are prompted for additional information if they select "no," allowing us to gain valuable insights into how we can improve recommendations in the future. Additionally, I discovered that specialists were responding to ProConsults from their mobile devices, prompting the decision to make the RubiconMD platform fully responsive.