When Dr. Clare Liddy shared with Dr. Erin Keely that one of her patients had to wait for more than nine months for an appointment with a specialist, they agreed this was too long. Together, they developed eConsult – and the electronic wait-time solution is spreading across Canada and around the world.
When Dr. Clare Liddy shared with Dr. Erin Keely that one of her patients had to wait for more than nine months for an appointment with a specialist, they agreed this was too long. Together, they set about solving the problem of extensive wait times to see specialists – a problem that seems to plague health-care systems.
That was in 2009. Now, their electronic eConsult solution is rolling out across Canada, and other countries are interested in it as well.
"Our goal is to have eConsult available across Canada for all Canadian patients," said Dr. Keely. "The primary care doctors and patients see the value right away, so it is solving a problem."
When they began, the two realized they could improve access for patients by making it easier for family doctors and specialists to communicate. So, Drs. Liddy and Keely launched an electronic consultation service.
Doctors and nurse practitioners can send questions and information about a particular patient's case to a specialist through a private and secure web page. The specialist then reviews the information and gives feedback about the patient without having to see the patient in person. Because the specialists provide their comments and advice quickly, turn-around time is less than a week, often only days.
This system, known as the Champlain BASE eConsult (short for Building Access to Specialists through eConsultation), started with just five specialty groups. By reaching out to their networks and informing other specialists about the system, that number grew to 109 specialty groups by 2018.
"I think it is hugely useful to patients because it allows referring doctors to receive answers in less than a week, as opposed to months for a referral visit," said Dr. Doug Smith, a rheumatology specialist at The Ottawa Hospital who has been involved with eConsult since the beginning.
"It helps me get answers quickly, which helps my patients, and also helps me make decisions about whether I need to send this person to see a specialist or not," said Dr. Kristina Whitehead, a family doctor.
Since 2011, the service has completed more than 35,000 cases and enrolled more than 1,300 primary care providers.
The eConsult success has started to spread across the province and the country. In its 2017 budget, the Ontario government committed to investing $245 million over three years to improve patient access to specialists, including rolling out eConsult across the province. Drs. Liddy and Keely have established the Ontario eConsult Centre of Excellence at The Ottawa Hospital in partnership with the Bruyère Research Institute and are leading the provincial government's initiative to expand eConsult across Ontario.
Quebec, Manitoba, Alberta, Newfoundland, and New Brunswick have now implemented eConsult. Primary care providers in Nunavut are also using the system, which is ideal for the north where the cost to transport patients is so high.
This successful initiative was also featured in the OHA's Stronger Together - Family Physicians and Hospitals Inspiring New Ways of Caring, a compendium of many creative and successful initiatives that exist throughout Ontario which are designed to strengthen relationships between family physicians and hospitals, and the positive impact they are having on patient care.