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Kelsey R Murray, Michael E Johansen
No abstract text is available yet for this article.
March 2018: Annals of Family Medicine
Clare Liddy, Isabella Moroz, Amir Afkham, Erin Keely
PURPOSE: Excessive wait times for specialist appointments pose a serious barrier to patient care. To improve access to specialist care and reduce wait times, we launched the Champlain BASE (Building Access to Specialists through eConsultation) eConsult service in April 2011. The objective of this study is to report on the impact of our multiple specialty eConsult service during the first 5 years of use after implementation, with a focus on growth and sustainability. METHODS: We conducted a cross-sectional study of all eConsult cases submitted between April 1, 2011 and April 30, 2016, and measured impact with system utilization data and mandatory close-out surveys completed at the end of each eConsult...
March 2018: Annals of Family Medicine
Erin Keely, Jennifer Li, Peter Magner, Amir Afkham, Clare Liddy
Background: The Champlain BASE™ (Building Access to Specialists through eConsultation) eConsult service allows primary care providers (PCPs) to submit patient-specific clinical questions to specialists via a secure web service. Objective: Our objective was to describe the types of nephrology questions asked through an eConsult service based in eastern Ontario and assess the service's impact on the need for face-to-face consultations. Design: Cross-sectional study using descriptive statistics was conducted using nephrology cases submitted between May 2011 and January 2015...
2018: Canadian Journal of Kidney Health and Disease
Douglas Archibald, Clare Liddy, Heather A Lochnan, Paul J Hendry, Erin J Keely
INTRODUCTION: Continuing professional development (CPD) offerings should address the educational needs of health care providers. Innovative programs, such as electronic consultations (eConsults), provide unique educational opportunities for practice-based needs assessment. The purpose of this study is to assess whether CPD offerings match the needs of physicians by coding and comparing session content to clinical questions asked through eConsults. METHODS: This study analyzes questions asked by primary care providers between July 2011 and January 2015 using a service that allows specialists to provide consultation over a secure web-based server...
January 16, 2018: Journal of Continuing Education in the Health Professions
Daren Anderson, Victor Villagra, Emil N Coman, Ianita Zlateva, Alex Hutchinson, Jose Villagra, J Nwando Olayiwola
OBJECTIVES: To evaluate the cost-effectiveness of electronic consultations (eConsults) for cardiology compared with traditional face-to-face consults. STUDY DESIGN: Cost-effectiveness analysis for a subset of Medicaid-insured patients in a cluster-randomized trial of eConsults versus the traditional face-to-face consultation process in a statewide federally qualified health center. METHODS: A total of 369 Medicaid patients were referred for cardiology consultations by primary care providers who were randomly assigned to use either eConsults or their usual face-to-face referral process...
January 1, 2018: American Journal of Managed Care
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
BACKGROUND: 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. OBJECTIVE: 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...
2018: PloS One
Eva van der Meij, Judith Af Huirne, A Dorien Ten Cate, Hein Bac Stockmann, Piet C Scholten, Paul Hp Davids, H Jaap Bonjer, Johannes R Anema
BACKGROUND: Electronic health (eHealth) interventions have proven effective, but implementation in clinical practice is difficult. More research focusing on the implementation process of eHealth interventions is necessary. OBJECTIVE: The objective of this study was to describe the process evaluation of a perioperative eHealth intervention, aiming to enhance recovery after laparoscopic abdominal surgery. METHODS: A process evaluation was carried out alongside a multicenter randomized controlled trial...
January 2, 2018: Journal of Medical Internet Research
Priscille Schettini, Kevin P Shah, Colin P O'Leary, Malhar P Patel, John B Anderson, Alex H Cho, Andrea L Long, Hayden B Bosworth, C Blake Cameron
Introduction Health systems are seeking innovative solutions to improve specialty care access. Electronic consultations (eConsults) allow specialists to provide formal clinical recommendations to primary care providers (PCPs) based on patient chart review, without a face-to-face visit. Methods We implemented a nephrology eConsult pilot program within a large, academic primary care practice to facilitate timely communication between nephrologists and PCPs. We used primary care referral data to compare wait times and completion rates between traditional referrals and eConsults...
January 1, 2017: Journal of Telemedicine and Telecare
Clare Liddy, Isabella Moroz, Amir Afkham, Erin Keely
OBJECTIVE: To replicate an existing electronic consultation (eConsult) service in a new jurisdiction to test its generalizability. METHODS: We conducted a cross-sectional study of all eConsults submitted by providers in the region of Mississauga Halton, Ontario, between January 5, 2015, and May 31, 2016. We compared our results to those from the original pilot in Eastern Ontario. The RE-AIM model served as our study framework. RESULTS: Providers submitted 594 patient cases to 46 different specialty groups during the study period...
November 2017: Healthcare Policy, Politiques de Santé
Patricia A Poulin, Heather C Romanow, Jeannette Cheng, Clare Liddy, Erin J Keely, Catherine E Smyth
Wait times for many chronic pain programs in Canada range from 6 months to 2 years. This project sought to determine the interest of primary care providers (PCPs) in using an electronic consult system for patient(s) waiting for a pain consultation. This cross-sectional study was conducted at the pain clinic of a Canadian tertiary academic health sciences center. Participants were PCPs who had submitted a referral to this clinic. Referrals received between April 1, 2012, and March 31, 2014, were reviewed to determine their appropriateness for eConsult, and a letter providing information about eConsult and encouraging its use was sent to the referring PCP...
November 14, 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
Clare Liddy, Catherine Smyth, Patricia A Poulin, Justin Joschko, Matthew Sheppard, Erin Keely
INTRODUCTION: Excessive wait times for chronic pain are associated with significant reductions in quality of life and worse health outcomes. The Champlain BASE™ (Building Access to Specialists through eConsultation) eConsult service can improve access to specialist care for patients with chronic pain by facilitating electronic communication between primary care providers (PCPs) and specialists. We explored the content of eConsult cases sent to chronic pain specialists to identify the major themes emerging from exchanges between PCPs and specialists regarding patients with chronic pain...
November 2017: Journal of the American Board of Family Medicine: JABFM
Leslie Skeith, Medina Mohamed, Alan Karovitch, Clare Liddy, Amir Afkham, Douglas Archibald, Erin Keely
INTRODUCTION: Electronic consultations (eConsults) are asynchronous, consultative electronic-based communications that are aimed to improve efficient and timely access to specialist advice. Our study aim was to evaluate the use and impact of the Canadian Champlain BASE™ (Building Access to Specialists through eConsultation) eConsult service in the specialty of thrombosis medicine. METHODS: We conducted a cross-sectional study that included descriptive statistics of provider and patient demographic information and consultative-specific data...
December 2017: Thrombosis Research
Kelly Stanistreet, Jenn Verma, Kirby Kirvan, Neil Drimer, Clare Liddy
While lengthy waits for medical specialists remains a persistent problem across Canada, remote consult presents a strategy to address this issue. Connecting primary healthcare providers to specialists via electronic (eConsult) or telephone consult enables care providers to deliver appropriate, speciality-informed care for their patients in the primary care setting, reducing the time spent waiting for specialists and potentially preventing unnecessary referrals to specialty care. These remote consult models are the focus of a new pan-Canadian quality improvement collaborative delivered by the Canadian Foundation for Healthcare Improvement in partnership with Canada Health Infoway, the College of Family Physicians of Canada and the Royal College of Physicians and Surgeons of Canada...
2017: Healthcare Quarterly
Jennifer L Pecina, Kirk D Wyatt, Nneka I Comfere, Matthew E Bernard, Frederick North
BACKGROUND: PhotoExam is a mobile app that incorporates digital photographs into the electronic health record (EHR) using iPhone operating system (iOS, Apple Inc)-based mobile devices. OBJECTIVE: The aim of this study was to describe usage patterns of PhotoExam in primary care and to assess clinician-level factors that influence the use of the PhotoExam app for teledermatology (TD) purposes. METHODS: Retrospective record review of primary care patients who had one or more photos taken with the PhotoExam app between February 16, 2015 to February 29, 2016 were reviewed for 30-day outcomes for rates of dermatology consult request, mode of dermatology consultation (curbside phone consult, eConsult, and in-person consult), specialty and training level of clinician using the app, performance of skin biopsy, and final pathological diagnosis (benign vs malignant)...
November 8, 2017: JMIR MHealth and UHealth
Krista Rostom, C Douglas Smith, Clare Liddy, Amir Afkham, Erin Keely
OBJECTIVE: To describe the use and benefits of an innovative eConsult service to improve access to rheumatologists. METHODS: There were 225 eConsults directed to rheumatology that were categorized by type of question and effect on face-to-face referral rates. RESULTS: The median response time by the rheumatologists was 1.9 days. Clinical questions included drug treatment (34%), diagnosis (26%), or management (14%). Osteoporosis was the most common diagnosis (22%), followed by pain in multiple joints (11%), and polyarthritis (10%)...
November 1, 2017: Journal of Rheumatology
Fludiona Naka, Jun Lu, Anthony Porto, Jose Villagra, Zhao Helen Wu, Daren Anderson
BACKGROUND: The clinical outcome of teledermatology with dermoscopy in large-scale primary care networks remains unclear. OBJECTIVE: We evaluate the impact of implementing a teledermatology consultation program with dermoscopy on a statewide scale, focusing on access to care and skin cancer screening for medically underserved populations. METHODS: Descriptive retrospective cohort study of 2385 dermatology referrals from primary care from June 2014 through November 2015...
October 20, 2017: Journal of the American Academy of Dermatology
Fanny McKellips, Erin Keely, Amir Afkham, Clare Liddy
BACKGROUND: Allied health services are an important part of providing effective team-based care. The Champlain BASE™ (Building Access to Specialists through eConsultation) eConsult service facilitates quick and secure communication between primary care providers (PCPs) and allied health professionals (AHPs). AIM: To assess the eConsult service's ability to improve access to advice from AHPs. DESIGN AND SETTING: A cross-sectional study was carried out on all cases submitted to AHPs through the eConsult service between April 2011 and May 2016...
November 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
Justin Joschko, Clare Liddy, Isabella Moroz, Marnie Reiche, Lois Crowe, Amir Afkham, Erin Keely
Background: Excessive wait times for specialist care can have a substantial negative impact on health outcomes. The Champlain BASETM (Building Access to Specialists through eConsultation) eConsult service based in Ottawa, Canada has demonstrated the ability to improve patients' access to specialist care. Objective: We interviewed patients who were treated using eConsult in order to explore their attitudes towards the service and their experiences of receiving care via the service...
August 8, 2017: Family Practice
Wendy H Oldenmenger, Mathilde A G Baan, Carin C D van der Rijt
BACKGROUND: In the outpatient setting, pain management is often inadequate in patients with cancer-related pain, because of patient- and professional-related barriers in communication and infrequent contacts. The internet may provide new opportunities for monitoring these patients. PURPOSE: The purpose of this study was to investigate whether internet monitoring of cancer-related pain in outpatients was feasible. METHODS: We developed an internet application that contained a pain diary, eConsult, and patient pain education...
September 19, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Clare Liddy, Paul Drosinis, Adam Fogel, Erin Keely
OBJECTIVE: To identify the proportion and evaluate the content of eConsults (electronic consultations) in which the Champlain BASE (Building Access to Specialists through eConsultation) eConsult process prompted a referral to a specialist that was not originally contemplated by the primary care provider (PCP). DESIGN: Cross-sectional study of all eConsults submitted between April 15, 2011, and January 31, 2015. SETTING: Champlain Local Health Integration Network, a large health region in eastern Ontario...
August 2017: Canadian Family Physician Médecin de Famille Canadien
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