PT  - JOURNAL ARTICLE
AU  - Jatinderpreet Singh
AU  - Gary E. Garber
AU  - Erin Keely
AU  - Sheena Guglani
AU  - Clare Liddy
TI  - Evaluation of an Electronic Consultation Service for COVID-19 Care
AID  - 10.1370/afm.2807
DP  - 2022 May 01
TA  - The Annals of Family Medicine
PG  - 220--226
VI  - 20
IP  - 3
4099  - http://www.annfammed.org/content/20/3/220.short
4100  - http://www.annfammed.org/content/20/3/220.full
SO  - Ann Fam Med2022 May 01; 20
AB  - PURPOSE COVID-19 has increased the need for innovative virtual care solutions. Electronic consultation (eConsult) services allow primary care practitioners to pose clinical questions to specialists using a secure remote application. We examined eConsult cases submitted to a COVID-19 specialist group in order to assess usage patterns, impact on response times and referrals, and the content of clinical questions being asked.METHODS This was a mixed-methods analysis of eConsult cases submitted between March and September 2020 in Ontario, Canada to 2 services. We performed a descriptive analysis of the average response time and the total time spent by the specialist for eConsults. Primary care practitioners completed a post-eConsult questionnaire that asked about the outcome of the eConsult. We performed an inductive and deductive content analysis of a subset of cases to identify common themes among the clinical questions asked.RESULTS A total of 208 primary care practitioners submitted 289 eConsult cases. The median specialist response time was 0.6 days (range = 3 minutes to 15 days); the average time spent by specialists per case was 16 minutes (range = 5 to 59 minutes). In 69 cases (24%), the eConsult enabled avoidance of a face-to-face referral. Content analysis of 51 cases identified 5 major themes: precautions for high-risk and special populations, diagnostic clarification and/or need for COVID-19 testing, guidance on self-isolation and return to work, guidance on personal protective equipment, and management of chronic symptoms.CONCLUSIONS This study demonstrates the considerable potential of eConsults during a pandemic as our service was quickly implemented across Ontario and resulted in primary care practitioners’ rapid and low-barrier access to specialist input.