RT Journal Article
SR Electronic
T1 Sustainability of a Primary Care–Driven eConsult Service
JF The Annals of Family Medicine
JO Ann Fam Med
FD American Academy of Family Physicians
SP 120
OP 126
DO 10.1370/afm.2177
VO 16
IS 2
A1 Clare Liddy
A1 Isabella Moroz
A1 Amir Afkham
A1 Erin Keely
YR 2018
UL http://www.annfammed.org/content/16/2/120.abstract
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.