Improving the Referral Process, Timeliness, Effectiveness, and Equity of Access to Specialist Medical Services Through Electronic Consultation: Pilot Study

Véronique Nabelsi; Annabelle Lévesque-Chouinard; Clare Liddy; Maxine Dumas Pilon

doi:10.2196/13354

Improving the Referral Process, Timeliness, Effectiveness, and Equity of Access to Specialist Medical Services Through Electronic Consultation: Pilot Study

JMIR Med Inform. 2019 Jul 10;7(3):e13354. doi: 10.2196/13354.

Authors

Véronique Nabelsi¹, Annabelle Lévesque-Chouinard², Clare Liddy^{3

4}, Maxine Dumas Pilon^{5

6}

Affiliations

¹ Département des Sciences Administratives, Université du Québec en Outaouais, Gatineau, QC, Canada.
² Groupe de Médecine de Famille Universitaires de Gatineau du Centre Intégré de Santé et des Services Sociaux de l'Outaouais, Gatineau, QC, Canada.
³ Department of Family Medicine, University of Ottawa, Ottawa, Ontario, ON, Canada.
⁴ CT Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, ON, Canada.
⁵ Department of Family Medicine, McGill University, Montréal, QC, Canada.
⁶ Collège Québécois des Médecins de Famille, Montréal, QC, Canada.

PMID: 31293239
PMCID: PMC6652123
DOI: 10.2196/13354

Abstract

Background: Access to specialty care remains a major challenge in the Canadian health care system. Electronic consultation (eConsult) services allow primary care providers to seek specialist advice often without needing the patient to go for a face-to-face consultation. It improves overall access to specialists and the referral process using an electronic care consultation service in urban and rural primary care clinics. This study describes the preliminary results of a pilot study with an eConsult service across 3 regions in the province of Quebec, Canada.

Objective: The main objective of this study was to provide a 1-year snapshot of the implementation of the eConsult Quebec Service in rural and urban primary care clinics to improve access to care and the specialty referral process for primary care providers (PCPs).

Methods: We established an eConsult service that covers urban and rural communities in 3 regions of Quebec. We conducted a quantitative analysis of all eConsult cases submitted from July 4, 2017, to December 8, 2018.

Results: For over a year, 1016 eConsults have been generated during the course of this study. A total of 97 PCPs submitted requests to 22 specialty groups and were answered by 40 different specialists. The most popular specialty was internal medicine (224/1016, 22%). Overall, 63% (640/1016) of completed cases did not require a face-to-face visit. PCPs rated the service as being of high or very high value for themselves in 98% (996/1016) of cases.

Conclusions: The preliminary data highlight the success of the implementation of the eConsult Quebec Service across 6 primary care clinics. The eConsult platform proves to be effective, efficient, and well received by both patients and physicians. If used more widely, eConsult could help reducing wait times significantly. Recently, the Ministry of Health and Social Services of Quebec has identified developing a strategic plan to scale eConsults throughout other regions of the province as a top priority.

Keywords: health information systems; physicians; primary health care; referrals; specialists.

©Véronique Nabelsi, Annabelle Lévesque-Chouinard, Clare Liddy, Maxine Dumas Pilon. Originally published in JMIR Medical Informatics (http://medinform.jmir.org), 10.07.2019.