Rheumatology to Pilot Reverse eConsults for Select Conditions Beginning December 15, 2025

Seattle Children’s Rheumatology will launch a Reverse eConsult pilot beginning December 15, 2025, to improve access to specialty care and ensure that resources are directed appropriately. The reverse eConsult process will help ensure in-person visits are reserved for patients who truly need specialist evaluation and to streamline care for those who can be effectively managed in the primary care setting. To support this pilot, we have updated the relevant algorithms, which are linked below and available online.

Please note, this pilot will apply only to patients residing in Washington State, as eConsults are not currently available outside the state.

How the Pilot Works

When a referral is submitted for one of the following conditions – diagnoses our Rheumatologists report rarely require a specialist visit – the referral will first undergo review by our Clinical Intake Nurses (CIN):

• ANA titer < 1:160 or ANA done by multiplex ELISA
• Henoch-Schönlein Purpura (HSP)
• Hypermobility
• Raynaud’s phenomenon

If an eConsult was previously submitted and outcome indicated the patient should be referred, the patient will be scheduled for an appointment. If no eConsult has been completed, the CIN team will send a faxback request asking the referring provider to submit an eConsult instead.

What Happens Next

• Rheumatology will monitor all referrals with outstanding eConsult requests.
• If the eConsult recommends an appointment, the patient will be scheduled.
• If the eConsult determines a visit is not needed, the referral will be closed after feedback is shared with the referring provider via the eConsult.
• If no eConsult is submitted within two weeks of the faxback, the referral will move forward for scheduling as next available.

This new process is designed to support timely access to specialty care for patients who need it most, while providing primary care providers with quick, evidence-based guidance for managing common rheumatologic concerns in the medical home.

For more information: Visit Rheumatology’s updated Refer a Patient page, and view the algorithms linked above.