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https://www.readbyqxmd.com/read/29320539/the-impact-of-electronic-consultation-on-a-canadian-tertiary-care-pediatric-specialty-referral-system-a-prospective-single-center-observational-study
#1
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
https://www.readbyqxmd.com/read/29295808/a-perioperative-ehealth-program-to-enhance-postoperative-recovery-after-abdominal-surgery-process-evaluation-of-a-randomized-controlled-trial
#2
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
https://www.readbyqxmd.com/read/29285981/keeping-care-connected-e-consultation-program-improves-access-to-nephrology-care
#3
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
https://www.readbyqxmd.com/read/29274229/evaluating-the-implementation-of-the-champlain-base%C3%A2-econsult-service-in-a-new-region-of-ontario-canada-a-cross-sectional-study
#4
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
https://www.readbyqxmd.com/read/29189436/offering-econsult-to-family-physicians-with-patients-on-a-pain-clinic-wait-list-an-outreach-exercise
#5
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
https://www.readbyqxmd.com/read/29180551/supporting-better-access-to-chronic-pain-specialists-the-champlain-base%C3%A2-econsult-service
#6
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
https://www.readbyqxmd.com/read/29145030/the-use-of-econsults-to-improve-access-to-specialty-care-in-thrombosis-medicine
#7
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...
November 7, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/29132445/physician-remuneration-for-remote-consults-an-overview-of-approaches-across-canada
#8
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
https://www.readbyqxmd.com/read/29117934/uses-of-mobile-device-digital-photography-of-dermatologic-conditions-in-primary-care
#9
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
https://www.readbyqxmd.com/read/29093155/improving-access-to-rheumatologists-use-and-benefits-of-an-electronic-consultation-service
#10
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
https://www.readbyqxmd.com/read/29061478/impact-of-dermatology-econsults-on-access-to-care-and-skin-cancer-screening-in-underserved-populations-a-model-for-teledermatology-services-in-community-health-centers
#11
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
https://www.readbyqxmd.com/read/28993307/improving-access-to-allied-health-professionals-through-the-champlain-base-%C3%A2-econsult-service-a-cross-sectional-study-in-canada
#12
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
https://www.readbyqxmd.com/read/28968806/just-a-click-away-exploring-patients-perspectives-on-receiving-care-through-the-champlain-basetm-econsult-service
#13
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
https://www.readbyqxmd.com/read/28929433/development-and-feasibility-of-a-web-application-to-monitor-patients-cancer-related-pain
#14
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
https://www.readbyqxmd.com/read/28807973/prevention-of-delayed-referrals-through-the-champlain-base-econsult-service
#15
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
https://www.readbyqxmd.com/read/28798830/improving-access-to-urologists-through-an-electronic-consultation-service
#16
Luke Witherspoon, Clare Liddy, Amir Afkham, Erin Keely, John Mahoney
INTRODUCTION: Access to specialist services is limited by wait times and geographic availability. Champlain Building Access to Specialist Advice (BASE) has been implemented in our service region to facilitate access to specialists by primary care providers (PCPs). Through a secure web-based system, PCPs are able to send eConsults instead of requesting a formal in-office consultation. METHODS: Urology eConsults completed through the Champlain BASE service from March 2013 to January 2015 were analyzed...
August 2017: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
https://www.readbyqxmd.com/read/28645288/a-cohort-study-of-a-general-surgery-electronic-consultation-system-safety-implications-and-impact-on-surgical-yield
#17
Jesus G Ulloa, Marika D Russell, Alice Hm Chen, Delphine S Tuot
BACKGROUND: Electronic consultation (eConsult) systems have enhanced access to specialty expertise and enhanced care coordination among primary care and specialty care providers, while maintaining high primary care provider (PCP), specialist and patient satisfaction. Little is known about their impact on the efficiency of specialty care delivery, in particular surgical yield (percent of ambulatory visits resulting in a scheduled surgical case). METHODS: Retrospective cohort of a random selection of 150 electronic consults from PCPs to a safety-net general surgery clinic for the three most common general surgery procedures (herniorrhaphy, cholecystectomy, anorectal procedures) in 2014...
June 23, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28585722/the-association-between-question-type-and-the-outcomes-of-a-dermatology-econsult-service
#18
Ashley O'Toole, Jiyeh Joo, Jean-Pierre DesGroseilliers, Clare Liddy, Steven Glassman, Amir Afkham, Erin Keely
BACKGROUND: eConsult is a web based service that facilitates communication between primary care providers (PCPs) and specialists, which can reduce the need for face-to-face consultations with specialists. One example is the Champlain BASE (Building Access to Specialist through eConsultation) service with dermatology being the largest specialty consulted. METHODS: Dermatology eConsults submitted from July 2011 to January 2015 were reviewed. Post eConsult surveys for PCPs were analyzed to determine the number of traditional consults avoided and perceived value of eConsults...
June 6, 2017: International Journal of Dermatology
https://www.readbyqxmd.com/read/28573644/improving-access-to-otolaryngology-head-and-neck-surgery-expert-advice-through-econsultations
#19
Scott Kohlert, Patrick Murphy, Darren Tse, Clare Liddy, Amir Afkham, Erin Keely
OBJECTIVES/HYPOTHESIS: Prolonged wait times have become common. Electronic consultations (eConsults) have been shown in previous studies to reduce unnecessary face-to-face consultations to specialists, but no prior study has investigated the feasibility or efficacy of eConsults in an otolaryngology-head and neck surgery (OTO-HNS) practice. STUDY DESIGN: Prospective observational study. METHODS: The Champlain BASE eConsult system is a secure web portal allowing primary care physicians (PCPs) to communicate asynchronously with specialists about a patient, without requiring a formal face-to-face consult...
June 2, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28570207/improving-access-to-specialists-in-remote-communities-a-cross-sectional-study-and-cost-analysis-of-the-use-of-econsult-in-nunavut
#20
Clare Liddy, Fanny McKellips, Catherine Deri Armstrong, Amir Afkham, Leigh Fraser-Roberts, Erin Keely
BACKGROUND: Residents of remote communities face inequities in access to specialists, excessive wait times, and poorly coordinated care. The Champlain BASE(TM) (Building Access to Specialists through eConsultation) service facilitates asynchronous communication between primary care providers (PCP) and specialists. The service was extended to several PCPs in Nunavut in 2014. OBJECTIVE: To (1) describe the use of eConsult services in Nunavut, and (2) conduct a costing evaluation...
2017: International Journal of Circumpolar Health
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