Dr. Erin Keely is Chief, Division of Endocrinology and Metabolism at The Ottawa Hospital and Professor in the Departments of Medicine and Obstetrics/Gynecology at the University of Ottawa.
Waiting for specialist care remains the number one barrier to health care access in Canada. Excessive wait times, poorly coordinated care, insufficient communication and duplication of testing can result in significant breakdowns in transition of care, inappropriate treatment, patient dissatisfaction and potential harm.
The Champlain BASE (Building Access to Specialist Care through eConsultation) project was developed to simplify and accelerate access to the expertise of medical specialists by primary care providers in order to improve care delivery to patients.
The eConsultation service is a secure, web-based system where primary care providers submit questions to specialists. Supplementary patient information, such as laboratory test results, digital images and health history can be attached to the referral, negating the need for sometimes costly or painful repetition of tests. The primary care provider usually gets a response from the specialist within 3 days. This is compared to, in some cases, the several months it would have taken for the patient to get an appointment with the specialist. It encourages providers to directly discuss cases together, which also improves the communication and relationship between primary and specialty care.
We now have about 25% of our primary care providers and 26 different specialty services using eConsultations. Over 1300 eConsultations have been received and in over 40% of cases the patients would have needed to come and see the specialist had the service not been available. Most eConsultations took the specialist less than 10 minutes to complete!
|Family physician Dr. Jennifer Ozard prepares an eConsultation|
Our simple eConsultation service has the potential to significantly reduce wait times by facilitating primary care providers getting specialty advice more efficiently without the need for the patient to see the specialist. In order to sustain and grow eConsultations as a sustainable solution to long wait times, changes in physician payment schedules, including fee codes for eConsultations are needed.
* CLICK HERE to watch the video featuring Dr. Keely and her colleagues on how BASE has improved communication between primary care physicians and specialists.