Sustainability of a Primary Care–Driven eConsult Service
Open accessAbstract
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.
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The Champlain BASE eConsult service specialists respond to cases in a median of 0.9 days and two-thirds of patients receive care without needing a face-to-face specialist visit.
“Specialists respond to cases in a median of 0.9 days and two-thirds of patients receive care without needing a face-to-face specialist visit [7].”
From Key factors for national spread and scale-up of an eConsult innovation (2020) · cites this paper as [7]
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Additional file 2 of Key factors for national spread and scale-up of an eConsult innovation
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Additional file 1 of Key factors for national spread and scale-up of an eConsult innovation
Moroz, I., Archibald, D., Breton, M., Côté-Boileau, É., Crowe, L., Horsley, T., Lirjie, H., Johar, G., Keely, E., Burns, K. K., et al. (2020) · Figshare · doi:10.6084/m9.figshare.12421817
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- Authors
- Liddy, C., Moroz, I., Afkham, A., & Keely, E.
- Affiliations
- University of Ottawa (CA)
- Bruyère (CA)
- Champlain Local Health Integration Network (CA)
- Venue
- The Annals of Family Medicine
- Publisher
- Annals of Family Medicine
- Published
- 2018-03
- Volume
- 16
- Issue
- 2
- Pages
- 120-126
- ISSN
- 1544-1709 (ISSN-L)
- 1544-1717
- PMC
- PMC5847349
- OpenAlex
- W2789287713
- Cited by
- 55
- References
- 17
- Citations by year
- 2026: 5 · 2025: 4 · 2024: 5 · 2023: 4 · 2022: 12 · 2021: 7 · 2020: 5 · 2019: 10 · 2018: 3
- FWCI
- 10.33
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Locations
- The Annals of Family Medicine (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Ontario Ministry of Health and Long-Term Care
- Topics
- Social Sciences › Business, Management and Accounting › Organizational Behavior and Human Resource Management › Healthcare Systems and Technology
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
- Keywords
- e-consultation, access to specialist care, service sustainability, system utilization
- MeSH terms
- Cross-Sectional Studies, Female, Health Plan Implementation, Health Services Accessibility, Humans, Male, Ontario, Primary Health Care, Specialization, Time Factors, Program Evaluation, Remote Consultation
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