Abstract We performed a case–control study to evaluate an electronic, asynchronous infectious diseases consultative service at 2 rural hospitals within our health system. Patients with consultation via this platform (n = 100) had a significantly decreased odds of death at 30 days compared with propensity-matched controls (n = 300; adjusted odds ratio, 0.3; 95% confidence interval, 0.2–0.7; P = .003).