AGA Abstracts queried. Non-GI diagnoses were found in 12 cases (7%). Topics were related to diagnostic approach (54%) and management (46%). Of management queries, 54% pertained to endos- copy or technical interpretation of lab results; the other 46% were for management of known diagnoses. Topics most commonly queried were chronic abdominal pain (26%), colon cancer screening (24%), and chronic diarrhea (18%). Mean response time to eConsult was 2.4 days compared to 78 days for face-to-face GI consultation. Mean mileage saved per case was 50 miles. Successful diagnosis or resolution of symptoms was achieved in 85 cases (52%) with eConsult alone. Face-to-face consultation was required in 51 cases (31%) of eConsults. Of the remaining 26 cases (16%), 10% have work-up in progress at time of the analysis, 3% were lost to follow-up, 2% were inappropriately triaged by eConsultant, and 1% were diagnosed with conditions that were not considered by the eConsultant. The most common queries that required face-to-face consultation included chronic abdominal pain (24%) and chronic diarrhea (20%). Conclusion: Despite lack of face-to-face contact, our eConsultant provided high quality advice which resolved the majority of clinical inquiries for a wide range of topics without delay in diagnosis. There appeared to be a trend that topics such as abdominal pain and chronic diarrhea may require face-to-face consultation; even in these cases, the eConsult model allowed PCPs to receive advice on pre-clinic evaluation. Future studies of eConsult in gastroenterology are needed to evaluate appropriate topics, assess satisfaction of patient, PCP and consultant, the quality of advice given, and effects on provider burnout. While rarely a problem in our model, extension to the entire community may be limited by access to medical records. S-222 AGA Abstracts Sa1003 DIAGNOSTIC COLONOSCOPY COMPLETION AFTER ABNORMAL FECAL IMMUNOCHEMICAL TESTING ACROSS 8 FEDERALLY QUALIFIED HEALTH CENTERS IN SOUTHERN CALIFORNIA: AN OPPORTUNITY FOR IMPROVING SCREENING OUTCOMES Balambal Bharti, Folasade (Fola) P. May, Jesse Nodora, Maria Elena Martinez, Karina Moyano, Shawne O'Connell, Felipe Garcia-Bigley, Kevin Ronan, Melissa Barajas, Sheree Gordon, Giselle Diaz, Evelyn Ceja, Meghan Powers, Christian B. Ramers, Shauntay Davis, Elva M. Arredondo, Samir Gupta Background: Colorectal cancer (CRC) screening saves lives, but is underutilized. At Federally Qualified Health Centers (FQHC), the largest providers of care to under- and uninsured individuals across the nation, much of the focus of screening efforts has been on promoting uptake of the fecal immunochemical test (FIT). A challenge of FIT based programs is that effectiveness depends on diagnostic colonoscopy follow up for abnormal FIT, as 1 in 30 individuals with abnormal FIT have CRC, and CRC-related death is increased in non- completers. Our aim was to characterize colonoscopy referral and colonoscopy completion among patients with abnormal FIT in FQHCs in Southern California. Methods: FQHCs in San Diego, Imperial, and Los Angeles counties were asked to define a cohort of $150 consecutive patients with abnormal FIT from 2015 to 2016. Participating centers then used manual chart review or electronic health record (EHR) queries to provide patient-level data for each cohort on gender, insurance status, and diagnostic colonoscopy and completion within 6 months of abnormal FIT. Primary outcomes were colonoscopy referral, and colonos- copy completion, characterized as the proportion with abnormal FIT (with 95% confidence intervals) for all patients in aggregate, as well as at each health center level. Results: Of 20 FQHCs invited, 8 participated. Pooled data for 1229 patients were available for analyses; 46% individuals were male and 20% were uninsured. Of 1229 patients with abnormal FIT, 1091 (89%) had a documented colonoscopy referral and just 539 (44%) had documentation of a completed colonoscopy (Table 2). The range for documented colonoscopy referral was 73% to 95% across participating FQHCs (FQHC mean = 88%). The range for colonoscopy completion was 18% to 57% (FQHC mean = 41%) across participating FQHCs. Conclusions: In a sample of 8 FQHCs in Southern California, uptake of diagnostic colonoscopy after abnormal FIT was low— substantially shy of the US Multi-Society Task Force on Colorectal Cancer's benchmark to achieve colonoscopy in 80% of patients with abnormal FITs. These findings suggest that effectiveness of CRC screening programs can be improved across a wide range of health centers caring for vulnerable populations by implementing policies and interventions that promote diagnostic colonoscopy among individuals with abnormal FIT. Sa1004 MULTI-DISCIPLINARY PRACTICE ADVANCEMENT: THE ROLE OF A CLINICAL PHARMACY SPECIALIST IN A PEDIATRIC GASTROENTEROLOGY CLINIC Catherine DeGeeter, Jessica Lynton Introduction: The optimization of specialty medications in an outpatient setting is becoming increasingly difficult. Limited distribution programs, changing reimbursement structures, medication authorization and an evolving complexity of medications complicate the provision of care. This burdensome system limits the time providers and nurses have to educate and monitor their patients on high risk medications. The outpatient Pediatric Specialty Clinic (PSC) at the University of Iowa Hospitals and Clinics developed a novel approach by placement of a clinical pharmacy specialist directly into clinical care. Methods: The PSC has 13 sub-specialties practicing out of one central location with an onsite Specialty Pharmacy that will service patients receiving specialty medications. With the unique difficulties of starting, educating, and monitoring patients on specialty medications, a clinical pharmacy specialist was placed into specialties within the PSC including gastroenterology. The services provided by the pharmacist include patient education, clinical recommendations, coordina- tion of insurance approval for specialty medication, copay assistance, and follow up monitor- ing. Standardized longitudinal follow-up is provided for patients that fill with the University's Specialty Pharmacy. Surveys were administered to patients and providers regarding their level of satisfaction with the pharmacist's role. Immunization rates and medication adherence were also examined. The pharmacist also provides indirect benefits via process improvement, policy revision, increased access to specialty products, and completion of literature searches. As an auxiliary benefit, the presence of a pharmacist increases the prescription capture rate at the specialty pharmacy, which in turn increases revenue for the hospital. Results: With implementation of a pharmacist into the PSC, there have been positive trends in adherence rate for injectable medications and PCV13 and PPSV23 immunization rates. For patients on a biologic medication and seen at least once by a pharmacist, the PCV-13 vaccination rates were 65% compared to 32% for those patients not followed by a pharmacist. Adherence