Electronic Consultation Services Worldwide: Environmental Scan

Joschko, Justin; Keely, Erin; Grant, Rachel; Moroz, Isabella; Graveline, Matthew; Drimer, Neil; Liddy, Clare

doi:10.2196/11112

Cited by 28 publications

(31 citation statements)

References 7 publications

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“…Telehealth technology is thus supposed to enhance frontline care providers’ virtual communication electronically. For example, care providers speak to patients via scheduled or on-demand/urgent visits; in addition, they communicate with specialists to ask questions and help patients avoid further face-to-face consultation with specialists [7]. Our main focus in this paper is on the latter case, often termed telespecialty consultation or e-consultation [8], which is the interaction between frontline care providers and specialists.…”

Section: Introductionmentioning

confidence: 99%

“…In the telehealth context, the adaptive use of telehealth technology is also expected, as health stakeholders increasingly use multiple technologies to communicate virtually with one another for care management beyond office visits. For example, care providers use personal messaging apps (eg, Whatsapp) and social network sites [11] to moderate communications between patients and care providers in addition to the designated telehealth technologies [7,38]. Hence, care providers’ adequate selection and use of other communication technologies may change the outcomes of telehealth services.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The Association Between Willingness of Frontline Care Providers’ to Adaptively Use Telehealth Technology and Virtual Service Performance in Provider-to-Provider Communication: Quantitative Study

Hah¹,

Goldin²,

Ha³

2019

J Med Internet Res

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Background Telehealth technology can create a disruptive communication environment for frontline care providers who mediate virtual communication with specialists in electronic consultations. As providers are dealing with various technology features when communicating with specialists, their flexible attitude and behaviors to use various telehealth-related technology features can change the outcome of virtual care service. Objective The objective of this study is to examine frontline care providers’ technology adaptation behaviors in the electronic consultation context. From the perspective of frontline care providers, we reapply and retest a theoretical model, reflecting a mechanism through which technology users’ personal characteristics and technology adaptation behavior enhance virtual service performance, which is an important performance enabler in this online meeting context. In provider-to-provider communication, particularly, we explore the association among providers’ information technology (IT)–related personal characteristics, adaptive telehealth technology use, and virtual service performance. Methods An online survey was administered to collect individual providers’ personal traits, IT adaptation, and perception on virtual service performance. Partial least squares-structural equation modeling was used to estimate our predictive model of personal traits—IT adaptation, such as exploitative use (use the telehealth technology in a standard way), and exploratory use (use the telehealth technology as innovative way)—and virtual service performance. Results We collected 147 responses from graduate nursing students who were training to be nurse practitioners in their master’s program, resulting in 121 valid responses from the cross-section online survey. Our theoretical model explained 60.0% of the variance in exploitative use of telehealth technology, 44% of the variance in exploratory use of telehealth technology, and 66% of the variance in virtual service performance. We found that exploitative IT use is an important driver to increase virtual service performance (β=0.762, P<.001), and personal characteristics such as habit are positively associated with both exploitative (β=0.293, P=.008) and exploratory use behaviors (β=0.414, P=.006), while computer self-efficacy is positively associated with exploitative use of telehealth technology (β=0.311, P=.047). Conclusions This study discusses the unique role of frontline care providers in a virtual care service context and highlights the importance of their telehealth adaptation behavior in provider-to-provider communication. We showed that providers perceive that telehealth technologies should function as intended, otherwise it may create frustration or avoidance of the telehealth technology. Moreover, providers’ habitual use of various technologies in daily lives also motivates them to adaptively use telehealth technology for improving virtual care service. Understanding providers’ technology habit and adaptation can inform health care policy and further provide a better view of the design of telehealth technology for online communication.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Association Between Willingness of Frontline Care Providers’ to Adaptively Use Telehealth Technology and Virtual Service Performance in Provider-to-Provider Communication: Quantitative Study

Hah¹,

Goldin²,

Ha³

2019

J Med Internet Res

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“…Despite the increased adoption of EHRs and eReferrals tools, faxed referrals for specialty care remain highly prevalent. 3 , 5–8 Smaller practices refer to a wide variety of specialty providers, and they lack technological infrastructure to develop custom integrations with each partner. While the EHR gives much needed structure to diverse clinical data, poor EHR interoperability is a major barrier to eliminating faxes from the workflow.…”

Section: Discussionmentioning

confidence: 99%

“…With the adoption of standards such as Direct and the Consolidated Clinical Document Architecture, health organizations have begun to shift toward use of electronic referrals (eReferrals) to streamline the referral process. 3 , 5–8 Adoption of this new technology is associated with greater provider satisfaction, improved transmission of key referral information, and reduction in healthcare spending. 9 , 10 However, external eReferrals only work if the participating health systems integrate their electronic health record (EHR) systems.…”

Section: Introductionmentioning

confidence: 99%

Design and development of Referrals Automation, a SMART on FHIR solution to improve patient access to specialty care

et al. 2020

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Background Referring patients to specialty care is an inefficient and error-prone process. Gaps in the referral process lead to delays in patients’ access to care, negative patient experience, worse health outcomes, and increased operational costs. While implementation of standards-based electronic referral options can alleviate some of these inefficiencies, many referrals to tertiary and quaternary care centers continue to be sent via fax. Objective We describe the design process and architecture for a software application that has been developed and deployed to optimize the referrals intake process by automating the processing and digitization of incoming specialty referral faxes, extracting key data elements and integrating them into the electronic health record (EHR), and organizing referrals. Methods A human-centered design approach was used to identify and describe the inefficiencies in the external referral process at our large, urban tertiary care center. Referrals Automation, an application to convert referral faxes to digital referrals in the EHR, was conceptualized based on key stakeholder interviews and time and motion studies. This application was designed using Substitutable Medical Applications and Reusable Technologies (SMART) and Fast Healthcare Interoperability Resource (FHIR) platforms to allow for adaptability into other healthcare organizations. Results Referrals Automation software was developed as a healthcare information technology solution to streamline the fax to referral process. The application was implemented into several specialty clinics. Metrics were built-in to the applications to evaluate and guide the further iteration of these features. Conclusions Referrals Automation will enhance the referrals process by further streamlining and organizing the patient referral process.

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“…A 2018 scoping review identified 53 versions of eConsult services in 16 countries and 1 international service, which differed in scope, technology platform, remuneration policies and engagement strategies. 6 In Canada, the most mature eConsult service is Champlain BASE (Building Access to Specialists through eConsultation). The service currently provides access to 114 specialty groups and processes more than 1000 cases each month, with a median response time of 21 hours and nearly two-thirds (65%) of cases resolved without requiring patients to attend a face-to-face specialist visit.…”

mentioning

confidence: 99%