Prevention of delayed referrals through the Champlain BASE eConsult service

Area of Science:

• Health Informatics
• Medical Telecommunications
• Primary Care Research

Background:

• Electronic consultations (eConsults) facilitate communication between primary care providers (PCPs) and specialists.
• The Champlain BASE (Building Access to Specialists through eConsultation) service aims to improve access to specialist advice.
• Understanding when eConsults lead to unplanned referrals is crucial for evaluating their impact.

Purpose of the Study:

• To determine the proportion of eConsults that prompted a specialist referral not originally planned by the PCP.
• To analyze the characteristics and outcomes of these prompted referrals.

Main Methods:

• A cross-sectional study analyzed 5601 eConsults submitted to the Champlain BASE service between April 2011 and January 2015.
• Data included PCP close-out surveys and review of specialist communication logs.
• Prompted referrals were categorized by specialty, question type, advice given, and urgency.

Main Results:

• 188 (3.4%) eConsults resulted in prompted specialist referrals.
• Cardiology and dermatology were the most common referral specialties.
• Diagnosis and drug treatment were the most frequent reasons for consultation, with 28% receiving pharmaceutical advice.

Conclusions:

• The Champlain BASE eConsult service plays a vital role in identifying potential specialist referrals.
• It helps mitigate risks associated with delayed medical care across various specialties.
• Enhanced access to specialists through eConsultation improves patient management pathways.