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eConsult pilot improving access to care

eConsult pilot improving access to care

Guest blog by Danielle Claus, Executive Director, Southeast Ontario Academic Medical Organization (SEAMO)

It’s no secret that lengthy wait times for specialist appointments are one of the biggest barriers to accessing health care in Ontario. Here, in our corner of the province, however, we are diligently chipping away at that obstacle, one eConsult at a time.

eConsults allow primary care providers (PCPs) to send patient-specific questions to specialists using a secure web-based platform. Specialists can then respond with advice, suggestions for treatment, or a recommendation that patients be seen by a specialist.

SEAMO, in collaboration with the Ontario Telemedicine Network (OTN), South East Local Health Integration Network (SELHIN), OntarioMD, and the Champlain BASE Project Team embarked on a six-month eConsult pilot project on Feb. 1, 2017. The goal of the pilot is to reduce the number of unnecessary referrals to Kingston specialists and to assist PCPs in better preparing patients for specialist appointments.

We are now halfway through the pilot, we have already seen the impact a timely, online conversation between a PCP and a specialist can have on patient care.

“I wish I had this years ago,” said Dr. Arawn Therrien, a family physician at Stone’s Mill Family Health Centre in Gananoque. “Patients are excited because I’m getting answers back within 48 hours.”

Therrien, who is the most active PCP in the pilot, went on to say that easier access to specialists through an online communication portal is ideal when a PCP wants to seek direction on a particular case or make minor adjustments to medication dosages.

Anecdotally, specialists are also noticing a decrease in the number of referrals received. Dermatologist Dr. Mark Kirchhof, who has answered 18 eConsults to date, believes the pilot has helped prevent referrals to his busy outpatient clinic.

“The wait time to see a dermatologist continues to increase, so any method to limit the in-person clinical demands benefits patients and the healthcare system,” he said.

As of Apr. 25, 2017, the project received a total of 144 eConsult requests from 38 different PCPs. The top five requested specialties are dermatology (29), cardiology (14), gastroenterology (13), neurology (13) and endocrinology (11). The average specialist response time is between 48 and to 72 hours.

The project has 124 active registered users — 52 PCPs and 72 specialists in 24 specialties. Early adopters of the new technology are using it often, with 70% of PCPs sending an eConsult request since the project launched. To date, three PCPs have sent 10 or more requests, seven have sent between five and nine requests, and 26 have sent between one and four requests.

Word of the pilot’s popularity continues to spread, with SEAMO receiving 19 new requests in April to join the project to join the pilot. With three months to go, we want to build on the momentum of the first half of the project and continue to increase access to health care for patients in our region.

I would to thank our PCPs and specialists for embracing this new technology in an effort to improve care in our region. For more information on the SEAMO eConsult Pilot Project, visit the SEAMO website.

Karen Schultz

Mon, 06/19/2017 - 13:58

As a primary care physician and Family Medicine preceptor I would just like to say how much I am appreciating this service. I have used this 4 times now–3 of those 4 meant I didn’t need to refer and care for that patient moved forward in a much more expedient way and 1 of them facilitated the referral by suggesting some investigations to do while the patient was waiting to be seen. It is also really nicely modeling for our residents very visible collaborative shared care with our specialist colleagues. Thanks!

Karen Schultz

Danielle Claus

Mon, 06/19/2017 - 13:58

Thank you for sharing your experience with the eConsult Pilot. We welcome your comments and plan to incorporate participant feedback in our analysis of the initiative.

Danielle Claus

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