Policy Innovation is Needed to Match Health Care Delivery Reform: The Story of the Champlain BASE eConsult Service

Liddy, Clare; Joschko, Justin; Keely, Erin

doi:10.13162/hro-ors.v3i2.2747

Cited by 7 publications

(8 citation statements)

References 12 publications

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“…Other systems, including Champlain BASE™, are supplemental and voluntary, relying on provider and patient interest to drive engagement. While barriers to eConsult's expansion exist and must be addressed, [15] the overall picture is encouraging, as evidenced by the experiences highlighted in our study. Furthermore, our own efforts at expansion have been highly successful: the service is currently expanding province-wide, and the College of Family Physicians of Canada recently released a statement identifying eConsult as a standard of practice.…”

Section: Comparison With Prior Workmentioning

confidence: 52%

Electronic Consultation Services Worldwide: Environmental Scan

Joschko¹,

Keely²,

Grant³

et al. 2018

J Med Internet Res

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Background: Excessive wait times for specialist care pose a serious concern for many patients, leading to duplication of tests, patient anxiety, and poorer health outcomes. In response to this issue, many healthcare systems have begun implementing technological innovations designed to improve the referral-consultation process. Among these services is electronic consultation (eConsult), which connects primary care providers and specialists via a secure platform to facilitate discussion of patients' care.

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Section: Comparison With Prior Workmentioning

confidence: 52%

Electronic Consultation Services Worldwide: Environmental Scan

Joschko¹,

Keely²,

Grant³

et al. 2018

J Med Internet Res

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“…Our team is aware of the challenges associated with eConsult's expansion and has previously examined the Canadian policy landscape to identify areas where legislation could impede eConsult's growth, revealing 3 aspects of concern: payment, privacy, and interjurisdictional licensing. 35 In an effort to overcome these obstacles, we applied an integrated knowledge translation strategy that culminated in a National eConsult Policy Think Tank, which convened experts and stakeholders from 9 Canadian provinces/territories. 36 It is our hope that these efforts will support the further expansion of the service to new jurisdictions across Canada.…”

Section: Discussionmentioning

confidence: 99%

Assessment of the Generalizability of an eConsult Service through Implementation in a New Health Region

Liddy¹,

Moroz²,

Mihan³

et al. 2019

J Am Board Fam Med

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Introduction: Excessive wait times for specialist care are a significant issue in many countries. Electronic consultation (eConsult) services have demonstrated the ability to improve access to specialist care. In this article, we evaluated the implementation of a successful eConsult service in a new jurisdiction to test its generalizability.Methods: We used a multimethod approach to evaluate the Champlain Building Access to Specialists through eConsultation eConsult service's implementation in the South East Local Health Integration Network of Ontario, Canada. Our quantitative analysis drew on use data collected automatically by the service and survey responses completed between February 1, and June 15, 2017. For our qualitative analysis, we conducted a thematic analysis of 3 focus groups with primary care providers and specialists participating in the pilot study.Results: Forty-nine out of the potential 219 primary care providers in Kingston submitted 301 cases to 24 specialty groups during the study period. Monthly case volume grew from 15 in February to 90 in May. The most frequently requested specialties included dermatology (n ‫؍‬ 59), cardiology (n ‫؍‬ 27), and gastroenterology (n ‫؍‬ 26). Specialists responded in a median of 2 days, and a referral was originally contemplated but ultimately avoided in 40% of cases. Providers spoke positively of the service, citing high levels of satisfaction, enhanced collegiality, increased trust, and improved patient flow.Conclusions: Adoption of the eConsult service in the South East Local Health Integration Network was successful. The service exceeded all adoption targets, and the number of completed cases demonstrated a consistently upward trend, suggesting continued growth beyond the study's duration. The service's rate of adoption, high levels of satisfaction, and use data similar to other regions all demonstrate eConsult's generalizability. (J Am Board Fam Med 2019;32:146 -157.)

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“…Wait times for specialized medical care are a major issue in the Canadian health care system [1-4]. Patients wait several weeks or months for an initial appointment.…”

Section: Introductionmentioning

confidence: 99%

“…This eConsult service has been extensively tested in eastern Ontario region, Canada, and currently operates as a fully funded program. eConsult BASE innovation has been reported to improve coordination in health systems by allowing direct communication between PCPs and specialists, improving access to shared records, and improving continuity of care by providing direct access to multiple specialty types [1,2,27,28]. eConsult BASE services reduce wait times for specialists, avoid unnecessary referrals, and therefore, have a large impact on costs [24,29].…”

Section: Introductionmentioning

confidence: 99%

Improving the Referral Process, Timeliness, Effectiveness, and Equity of Access to Specialist Medical Services Through Electronic Consultation: Pilot Study

et al. 2019

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Background Access to specialty care remains a major challenge in the Canadian health care system. Electronic consultation (eConsult) services allow primary care providers to seek specialist advice often without needing the patient to go for a face-to-face consultation. It improves overall access to specialists and the referral process using an electronic care consultation service in urban and rural primary care clinics. This study describes the preliminary results of a pilot study with an eConsult service across 3 regions in the province of Quebec, Canada. Objective The main objective of this study was to provide a 1-year snapshot of the implementation of the eConsult Quebec Service in rural and urban primary care clinics to improve access to care and the specialty referral process for primary care providers (PCPs). Methods We established an eConsult service that covers urban and rural communities in 3 regions of Quebec. We conducted a quantitative analysis of all eConsult cases submitted from July 4, 2017, to December 8, 2018. Results For over a year, 1016 eConsults have been generated during the course of this study. A total of 97 PCPs submitted requests to 22 specialty groups and were answered by 40 different specialists. The most popular specialty was internal medicine (224/1016, 22%). Overall, 63% (640/1016) of completed cases did not require a face-to-face visit. PCPs rated the service as being of high or very high value for themselves in 98% (996/1016) of cases. Conclusions The preliminary data highlight the success of the implementation of the eConsult Quebec Service across 6 primary care clinics. The eConsult platform proves to be effective, efficient, and well received by both patients and physicians. If used more widely, eConsult could help reducing wait times significantly. Recently, the Ministry of Health and Social Services of Quebec has identified developing a strategic plan to scale eConsults throughout other regions of the province as a top priority.

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Policy Innovation is Needed to Match Health Care Delivery Reform: The Story of the Champlain BASE eConsult Service

Cited by 7 publications

References 12 publications

Electronic Consultation Services Worldwide: Environmental Scan

Electronic Consultation Services Worldwide: Environmental Scan

Assessment of the Generalizability of an eConsult Service through Implementation in a New Health Region

Improving the Referral Process, Timeliness, Effectiveness, and Equity of Access to Specialist Medical Services Through Electronic Consultation: Pilot Study

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