PT  - JOURNAL ARTICLE
AU  - Liddy, Clare
AU  - Moroz, Isabella
AU  - Afkham, Amir
AU  - Keely, Erin
TI  - Sustainability of a Primary Care–Driven eConsult Service
AID  - 10.1370/afm.2177
DP  - 2018 Mar 01
TA  - The Annals of Family Medicine
PG  - 120--126
VI  - 16
IP  - 2
4099  - http://www.annfammed.org/content/16/2/120.short
4100  - http://www.annfammed.org/content/16/2/120.full
SO  - Ann Fam Med2018 Mar 01; 16
AB  - 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.