The care of complex patients is fragmented and poorly coordinated between referring primary care providers (PCPs) and specialists. Systemic issues include ill-defined referral indications, poor communication between physicians, and recommendations from specialists that are thought by PCPs to be unclear.1,2 There is a need to improve the efficiency of delivering specialist services3; this involves ensuring that patients who benefit most from in-person consultation receive timely care and identifying patients for whom in-person consultation may not be necessary.