The Provincial Spread and Scale of the Ontario eConsult Service: Evaluation of the First 2 Years.

This paper reports on a multimethod cross-sectional study of the Ontario electronic consultation (eConsult) service. Utilization and closeout survey data from July 2018 through June 2020 were analyzed using the Reach Effectiveness Adoption Implementation Maintenance (RE-AIM) framework. Requesting clinicians submitted 60,474 eConsults, and monthly cases increased from 1,487 in July 2018 to 4,179 in June 2020. The median specialist response time was 1 day. An originally contemplated referral was avoided in 51% of cases. Ontario eConsult showed successful uptake across Ontario, demonstrating continued spread and scale, and offering a template for trailblazers looking to implement digital health innovations in their own jurisdictions.