Dataset Information

Evaluation of an Electronic Consultation Service for COVID-19 Care.

ABSTRACT:

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.

SUBMITTER: Singh J

PROVIDER: S-EPMC9199057 | biostudies-literature | 2022 May-Jun

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Evaluation of an Electronic Consultation Service for COVID-19 Care.

Singh Jatinderpreet J Garber Gary E GE Keely Erin E Guglani Sheena S Liddy Clare C

Annals of family medicine 20220501 3

<h4>Purpose</h4>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.<h4>Methods</h4>This was a mixed-methods analysis of eConsult case ...[more]

PMID: 35606132

Similar Datasets

Project description:Aims and objectivesTo describe characteristics of service utilization by advanced practice nurses (APNs) employing an electronic consultation (eConsult) service in their care for older adults.BackgroundCanada's aging population is projected to place unprecedented demands on the healthcare system. APNs, which include clinical nurse specialists (CNSs) and nurse practitioners (NPs), are nurses with advanced knowledge who can independently provide age-appropriate care. eConsult is a secure web-based platform enabling asynchronous, provider-to-provider communication. APNs can send and receive eConsults to address patient-specific concerns.MethodsThis is a retrospective analysis of eConsult utilization and user survey data for cases completed in 2019, reported in line with the STROBE guidelines. Eligible eConsults included those that had APN involvement (as a referrer or responder) and were concerning an older patient (≥65 years). Descriptive statistics were used to analyse service utilization and survey response data.ResultsOf 430 eligible eConsults, 421 (97.9%) were initiated by NPs and the rest by physicians. 23 (5.3%) were received by a CNS, of which 14 (3.3%) involved an NP-to-CNS exchange. Median specialist response interval was 0.9 days. 53% of eConsults was for dermatology, haematology, cardiology, gastroenterology and endocrinology. 73% of eConsults avoided a face-to-face referral after the consultation. In 90% of eConsults, APNs rated the service as helpful and/or educational.ConclusionsThrough eConsult, APNs can collaborate with each other and physicians to access and provide a breadth of advice facilitating timely specialist-informed care for older patients, thus helping to alleviate some of the demands placed on the healthcare system.Relevance to clinical practiceThere is an opportunity for APNs to further adopt eConsult into their clinical practice, and this can, in turn, support the integration of the APN role in the health workforce.Patient or public contributionCurrent APN eConsult users were involved in the study design and interpretation of results.

Project description:Background: Patients with complex circumstances pertaining to geography, socioeconomic status, or functional health often face inequities in accessing care. Electronic consultation (eConsult) is a secure online application that allows primary care providers (PCPs) and specialists to communicate regarding a patient's care. eConsult has demonstrated an ability to improve access to specialist care, and may be of particular use in cases of inequitable access. Methods: We examined how eConsult is used to improve equity of access for patients in complex circumstances by conducting a multiple case study of eConsults from seven patient groups: addiction, frail elderly, homeless, long-term care, rural, special needs, and transgender. Cases from these groups were selected from all eConsult cases completed between January 1 and December 31, 2017 using a data collection strategy tailored to each group. An access framework by Levesque et al. was applied to the data to examine five dimensions of access, arranged in chronological order, that reflect the process of a patient seeking care: approachability, acceptability; availability, affordability, and appropriateness. Two reviewers analyzed the cases using an iterative approach, regularly presenting findings to the research team for discussion and interpretation. Results: Eight hundred and twenty-five cases emerged across the seven target groups. The selected cases highlighted a number of key factors, including the value of the patient-PCP relationship, the importance of considering patient perspectives when providing care, and efforts to accommodate patients facing particular challenges to accessing care. Examples emerged among all five dimensions of the Levesque et al. access framework, with the final dimension, appropriateness, emerging across all cases. Conclusions: By leveraging the eConsult platform, PCPs can help improve equitable access to specialist care. More research is needed to understand why patients with complex circumstances face a longer wait time compared to the general population, and the impact that eConsults can have in improving health outcomes and wait times for this population.

Dataset Information

Evaluation of an Electronic Consultation Service for COVID-19 Care.

Purpose

Methods

Results

Conclusions

Publications

Evaluation of an Electronic Consultation Service for COVID-19 Care.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets