PLoS ONE (Jan 2018)

The impact of electronic consultation on a Canadian tertiary care pediatric specialty referral system: A prospective single-center observational study.

  • Lillian Lai,
  • Clare Liddy,
  • Erin Keely,
  • Amir Afkham,
  • Julia Kurzawa,
  • Nishard Abdeen,
  • Tobey Audcent,
  • Matthew Bromwich,
  • Jason Brophy,
  • Sasha Carsen,
  • Annick Fournier,
  • Leigh Fraser-Roberts,
  • Hazen Gandy,
  • Charles Hui,
  • Donna Johnston,
  • Kathryn Keely,
  • Ken Kontio,
  • Christine Lamontagne,
  • Nathalie Major,
  • Michael O'Connor,
  • Dhenuka Radhakrishnan,
  • Joe Reisman,
  • Marjorie Robb,
  • Lindy Samson,
  • Erick Sell,
  • William Splinter,
  • Judy van Stralen,
  • Sunita Venkateswaran,
  • Kimmo Murto

DOI
https://doi.org/10.1371/journal.pone.0190247
Journal volume & issue
Vol. 13, no. 1
p. e0190247

Abstract

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Champlain BASE™ (Building Access to Specialists through eConsultation) is a web-based asynchronous electronic communication service that allows primary-care- practitioners (PCPs) to submit "elective" clinical questions to a specialist. For adults, PCPs have reported improved access and timeliness to specialist advice, averted face-to-face specialist referrals in up to 40% of cases and high provider satisfaction.To determine whether the expansion of eConsult to a pediatric setting would result in similar measures of improved healthcare system process and high provider acceptance reported in adults.Prospective observational cohort study.Single Canadian tertiary-care academic pediatric hospital (June 2014-16) servicing 1.2 million people.1. PCPs already using eConsult. 2.Volunteer pediatric specialists provided services in addition to their regular workload. 3.Pediatric patients (93.3%) of PCPs rated eConsult as very good/excellent value for both patients and themselves. All specialist survey-respondents indicated eConsult should be a continued service.Similar to adults, eConsult improves PCP access and timeliness to elective pediatric specialist advice and influences their care decisions, while reporting high end-user satisfaction. Further study is warranted to assess impact on resource utilization and clinical outcomes.