Ten Steps to Establishing an e-Consultation Service to Improve Access to Specialist Care

Clare E. Liddy · Julie Maranger · Amir Afkham

93 citations0/0 files storedTelemedicine Journal and e-Health

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Healthcare Systems and Technology Electronic Health Records Systems Telemedicine and Telehealth Implementation

Abstract

There is dissatisfaction among primary care physicians, specialists, and patients with respect to the consultation process. Excessive wait times for receiving specialist services and inefficient communication between practitioners result in decreased access to care and jeopardize patient safety. We created and implemented an electronic consultation (e-consultation) system in Eastern Ontario to address these problems and improve the consultation process. The e-consultation system has passed through the proof-of-concept and pilot study stages and has effectively reduced unnecessary referrals while receiving resoundingly positive feedback from physician-users. Using our experience, we have outlined the 10 steps to developing an e-consultation service. We detail the technical, administrative, and strategic considerations with respect to (1) identifying your partners, (2) choosing your platform, (3) starting as a pilot project, (4) designing your product, (5) ensuring patient privacy, (6) thinking through the process, (7) fostering relationships with your participants, (8) being prepared to provide physician payment, (9) providing feedback, and (10) planning the transition from pilot to permanency. In following these 10 steps, we believe that the e-consultation system and its associated improvements on the consultation process can be effectively implemented in other healthcare settings.

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2013Utilization, Benefits, and Impact of an e-Consultation Service Across Diverse Specialties and Primary Care Providers

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2016What are the cost savings associated with providing access to specialist care through the Champlain BASE eConsult service? A costing evaluation 2015E-referral Solutions: Successful Experiences, Key Features and Challenges- a Systematic Review 2017Improving access to otolaryngology–head and neck surgery expert advice through eConsultations 2018The impact of electronic consultation on a Canadian tertiary care pediatric specialty referral system: A prospective single-center observational study 2019Improving the Referral Process, Timeliness, Effectiveness, and Equity of Access to Specialist Medical Services Through Electronic Consultation: Pilot Study 2017Patient and provider perspectives on the design and implementation of an electronic consultation system for kidney care delivery in Canada: a focus group study 2016Econsults to Endocrinologists Improve Access and Change Primary Care Provider Behavior 2017Keeping care connected: e-Consultation program improves access to nephrology care

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