The breaking point for Dr. Clare Liddy, a family physician, came 10 years ago when she received an email that highlighted the waiting game that patients face when it comes to accessing specialist care.
“I had referred a patient to the endocrinology clinic. The message that I got back was thank you very much for the referral; please let them know that they will be seen in six to nine months,” said Dr. Liddy.
Together with her colleague, endocrinologist Dr. Erin Keely, FRCPC, they figured they could either wait for someone else to fix the problem or work together to improve the system.
The result of their brainstorm sessions was Champlain BASE™ (Building Access to Specialists through eConsultation) known as eConsult. It’s a secure, web-based platform that connects primary care physicians and nurse practitioners with specialists to discuss non-urgent patient cases.
The pilot program started with five specialists and 15 family doctors in Winchester, Ont. Within a year, the service connected family doctors with 27 specialty groups. eConsult now has over 111 specialty groups. Word of mouth has been the biggest driver of growth.
“One primary care provider would tell another how great eConsult is and that they should have access to it,” said Dr. Keely. “We used our network and went after people who wanted to help and engage with their primary care colleagues.”
Key facts about eConsults
- The average response time for an eConsult is two days
- 28,792 – the number of eConsult cases completed without the patient requiring a face-to-face specialist visit
- 64 national research publications
- 97 per cent of eConsult patients surveyed consider this service to be an acceptable alternative to traditional face-to-face referrals
- 94 per cent of eConsult specialists surveyed state that this service improves inter-provider communication
- $47.35 is the average cost of an eConsult, compared to $133.60 for traditional referrals
- Specialists and primary care users provide feedback after each eConsult, leading to a better understanding and learning around a patient’s case
**Stats from www.champlainbaseeconsult.com (July 2018)
Measured growth, immeasurable impact
Drs. Liddy and Keely made sure the benefits of their eConsults were grounded in solid evidence. Their success has drawn a great deal of interest. They have acquired over $2 million dollars in funding for operational support and research for the eConsult service from organizations such as the Royal College and the Canadian Institutes of Health Research.
Through this funding, they have established a national collaborative and a program of research grounded in the Quadruple Aim framework, showing benefits in the following categories
- improving the health of populations,
- enhancing the patient experience of care,
- reducing the cost of health care, and
- providing improved work/life balance for health care providers.
Their eConsult model is growing in Ontario – 85,000 patients have benefited from the service so far. They are also seeing growth across the country: eConsult services or initial projects based on their model are underway in Newfoundland and Labrador, New Brunswick, Québec, Manitoba and Alberta.
November 1st marks the third annual eConsult policy forum, hosted this year hosted by the Royal College in Ottawa. This year’s forum topic is “Building on a BASE™ of Success: Establishing best practices for eConsult/eReferral in Canada.”
Though rewarding to see the growth of eConsults throughout Canada, its success is rooted in seeing the positive impact the service has had on patients.
“One gentleman who lives an hour outside of the city was able to have an eConsult done through his family doctor, which he said ended up saving him a visit to the specialist. This was not only good for him, but saved a visit for his son who normally would’ve accompanied him on these types of specialist visits,” said Dr. Liddy.
Dr. Keely added, “The eConsult has promoted a better relationship between primary care and the specialist community. We’ve been able to provide a really positive communication tool that everyone knows is all about helping patients and that’s what we’ve been able to do.”
Want to find out if eConsult is available in your region? Contact eConsultCOE@toh.ca