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!
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| 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.
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