Literature DB >> 29531102

Sustainability of a Primary Care-Driven eConsult Service.

Clare Liddy1,2, Isabella Moroz3, Amir Afkham4, Erin Keely5,6.   

Abstract

PURPOSE: Excessive wait times for specialist appointments pose a serious barrier to patient care. To improve access to specialist care and reduce wait times, we launched the Champlain BASE (Building Access to Specialists through eConsultation) eConsult service in April 2011. The objective of this study is to report on the impact of our multiple specialty eConsult service during the first 5 years of use after implementation, with a focus on growth and sustainability.
METHODS: We conducted a cross-sectional study of all eConsult cases submitted between April 1, 2011 and April 30, 2016, and measured impact with system utilization data and mandatory close-out surveys completed at the end of each eConsult. Impact indicators included time interval to obtain specialist advice, effect of specialist advice on the primary care clinician's course of action, and rate of avoidance of face-to-face visits.
RESULTS: A total of 14,105 eConsult cases were directed to 56 different medical specialty groups, completed with a median response time of 21 hours, and 65% of all eConsults were resolved without a specialist visit. We observed rapid growth in the use of eConsult during the study period: 5 years after implementation the system was in use by 1,020 primary care clinicians, with more than 700 consultations taking place per month.
CONCLUSIONS: This study presents the first in-depth look at the growth and sustainability of the multispecialty eConsult service. The results show the positive impact of an eConsult service and can inform other regions interested in implementing similar systems.
© 2018 Annals of Family Medicine, Inc.

Entities:  

Keywords:  access to care; eConsult; electronic consultation; health equity; primary care; referral; telemedicine; wait times

Mesh:

Year:  2018        PMID: 29531102      PMCID: PMC5847349          DOI: 10.1370/afm.2177

Source DB:  PubMed          Journal:  Ann Fam Med        ISSN: 1544-1709            Impact factor:   5.166


  12 in total

Review 1.  Diffusion of innovations in service organizations: systematic review and recommendations.

Authors:  Trisha Greenhalgh; Glenn Robert; Fraser Macfarlane; Paul Bate; Olivia Kyriakidou
Journal:  Milbank Q       Date:  2004       Impact factor: 4.911

2.  Impact of CPOE on mortality rates--contradictory findings, important messages.

Authors:  E Ammenwerth; J Talmon; J S Ash; D W Bates; M-C Beuscart-Zéphir; A Duhamel; P L Elkin; R M Gardner; A Geissbuhler
Journal:  Methods Inf Med       Date:  2006       Impact factor: 2.176

3.  Utilization, benefits, and impact of an e-consultation service across diverse specialties and primary care providers.

Authors:  Erin Keely; Clare Liddy; Amir Afkham
Journal:  Telemed J E Health       Date:  2013-08-27       Impact factor: 3.536

4.  Implementation of an electronic referral system for outpatient specialty care.

Authors:  Susan G Straus; Alice Hm Chen; Half Yee; Margot B Kushel; Douglas S Bell
Journal:  AMIA Annu Symp Proc       Date:  2011-10-22

5.  Electronic consultation as an alternative to hospital referral for patients with chronic kidney disease: a novel application for networked electronic health records to improve the accessibility and efficiency of healthcare.

Authors:  John Stoves; John Connolly; Chee Kay Cheung; Angela Grange; Penny Rhodes; Donal O'Donoghue; John Wright
Journal:  Qual Saf Health Care       Date:  2010-06-16

Review 6.  The current state of electronic consultation and electronic referral systems in Canada: an environmental scan.

Authors:  Clare Liddy; Matthew Hogel; Valerie Blazkho; Erin Keely
Journal:  Stud Health Technol Inform       Date:  2015

Review 7.  Electronic consultation systems: worldwide prevalence and their impact on patient care-a systematic review.

Authors:  Clare Liddy; Paul Drosinis; Erin Keely
Journal:  Fam Pract       Date:  2016-04-13       Impact factor: 2.267

8.  Evaluating electronic referrals for specialty care at a public hospital.

Authors:  Judy E Kim-Hwang; Alice Hm Chen; Douglas S Bell; David Guzman; Hal F Yee; Margot B Kushel
Journal:  J Gen Intern Med       Date:  2010-05-29       Impact factor: 5.128

Review 9.  Electronic consultations (e-consults) to improve access to specialty care: a systematic review and narrative synthesis.

Authors:  Varsha G Vimalananda; Gouri Gupte; Siamak M Seraj; Jay Orlander; Dan Berlowitz; Benjamin G Fincke; Steven R Simon
Journal:  J Telemed Telecare       Date:  2015-05-20       Impact factor: 6.184

10.  Building access to specialist care through e-consultation.

Authors:  Clare Liddy; Margo S Rowan; Amir Afkham; Julie Maranger; Erin Keely
Journal:  Open Med       Date:  2013-01-08
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  10 in total

1.  Transforming the specialist referral and consultation process in Canada.

Authors:  Erin Keely; Clare Liddy
Journal:  CMAJ       Date:  2019-04-15       Impact factor: 8.262

2.  Electronic consultations (E-consults) and their outcomes: a systematic review.

Authors:  Varsha G Vimalananda; Jay D Orlander; Melissa K Afable; B Graeme Fincke; Amanda K Solch; Seppo T Rinne; Eun Ji Kim; Sarah L Cutrona; Dylan D Thomas; Judith L Strymish; Steven R Simon
Journal:  J Am Med Inform Assoc       Date:  2020-03-01       Impact factor: 4.497

3.  Characterising Australian memory clinics: current practice and service needs informing national service guidelines.

Authors:  Sharon L Naismith; Johannes C Michaelian; Lee-Fay Low; Valerie Arsenova; Inga Mehrani; Katrina Fyfe; Nicole A Kochan; Susan E Kurrle; Christopher Rowe; Perminder S Sachdev
Journal:  BMC Geriatr       Date:  2022-07-14       Impact factor: 4.070

4.  Key factors for national spread and scale-up of an eConsult innovation.

Authors:  Isabella Moroz; Douglas Archibald; Mylaine Breton; Elizabeth Cote-Boileau; Lois Crowe; Tanya Horsley; Lirjie Hyseni; Gina Johar; Erin Keely; Katharina Kovacs Burns; Craig Kuziemsky; Jim Laplante; Ariana Mihan; Luis Oppenheimer; Don Sturge; Delphine S Tuot; Clare Liddy
Journal:  Health Res Policy Syst       Date:  2020-06-03

5.  Supporting the spread and scale-up of electronic consultation across Canada: cross-sectional analysis.

Authors:  Clare Liddy; Aminu Bello; Jean Cook; Neil Drimer; Maxine Dumas Pilon; Gerard Farrell; Jodi Glassford; Laurie Ireland; Rana McDonald; Véronique Nabelsi; Luis Oppenheimer; Alex Singer; Erin Keely
Journal:  BMJ Open       Date:  2019-05-30       Impact factor: 2.692

6.  Impact of the Connected Medicine collaborative in improving access to specialist care: a cross-sectional analysis.

Authors:  Clare Liddy; Emma Boulay; Lois Crowe; Maxine Dumas-Pilon; Neil Drimer; Gerard Farrell; Laurie Ireland; Christine Kirby Kirvan; Veronique Nabelsi; Alexander Singer; Margot Wilson; Erin Keely
Journal:  CMAJ Open       Date:  2021-12-14

7.  Evaluation of the First Year(s) of Physicians Collaboration on an Interdisciplinary Electronic Consultation Platform in the Netherlands: Mixed Methods Observational Study.

Authors:  Henk van der Worp; Danielle Jansen; Paul Koning; Marco H Blanker; Sanne M Sanavro
Journal:  JMIR Hum Factors       Date:  2022-04-01

8.  Barriers and Benefits of the Scheduled Telephone Referral Model (DETELPROG): A Qualitative Approach.

Authors:  Luis Miguel Azogil-López; Valle Coronado-Vázquez; Juan José Pérez-Lázaro; Juan Gómez-Salgado; Esther María Medrano-Sánchez
Journal:  Int J Environ Res Public Health       Date:  2021-05-16       Impact factor: 3.390

9.  Comparing the content of traditional faxed consultations to eConsults within an academic endocrinology clinic.

Authors:  Nicole Pun; Amel Arnaout; Christopher Tran; Clare Liddy; Erin Keely
Journal:  J Clin Transl Endocrinol       Date:  2021-06-18

10.  Perspectives of VA Primary Care Clinicians Toward Electronic Consultation-Related Workload Burden: A Qualitative Analysis.

Authors:  Marcie Lee; Chelsea Leonard; Preston Greene; Rachael Kenney; Melanie D Whittington; Susan Kirsh; P Michael Ho; George Sayre; Joseph Simonetti
Journal:  JAMA Netw Open       Date:  2020-10-01
  10 in total

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