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Evolving Toward Shared HIV Care Using the Champlain BASE eConsult Service.

Claire E Kendall1, Janessa E Porter1, Esther S Shoemaker1

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Summary
This summary is machine-generated.

Electronic consultations (eConsults) enhance HIV care by connecting primary care providers with specialists. This service is highly valued for improving access to expertise and facilitating comprehensive, team-based care for people living with HIV.

Keywords:
HIVchronic disease managementcomorbidityelectronic consultationprimary care

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Area of Science:

  • Infectious Diseases
  • Health Informatics
  • Primary Care Medicine

Background:

  • Electronic consultation (eConsultation) services offer a pathway to improve specialist access and collaborative care.
  • The Champlain BASE eConsult service facilitates secure, asynchronous communication between primary care providers (PCPs) and HIV specialists.
  • Available HIV expertise includes physician specialists, pharmacists, and social workers.

Purpose of the Study:

  • To evaluate the utilization, perceived value, and clinical utility of an eConsultation service for patients with HIV.
  • To identify common types of questions and clinical topics addressed via eConsultation by PCPs.
  • To characterize the role of eConsultation in managing complex HIV cases and facilitating coordinated care.

Main Methods:

  • Analysis of eConsult data submitted to the HIV specialty group in Ontario's Champlain Local Health Integration Network (February 2015 - December 2017).
  • Descriptive statistics applied to usage data and close-out survey responses.
  • Classification of eConsults using a validated taxonomy and thematic analysis of consultation logs for clinical themes.

Main Results:

  • Drug treatment (58.7%) and management (19.6%) were the most frequent eConsult question types.
  • Key clinical themes included managing comorbidities, drug interactions, and coordinating care for complex HIV cases.
  • eConsults were also utilized for pre-exposure prophylaxis (PrEP) advice for HIV-negative individuals at risk.
  • Primary care providers reported high satisfaction with the service (average rating 4.8/5).

Conclusions:

  • The eConsult service is an efficient and valuable tool for PCPs managing patients with or at risk for HIV.
  • It improves access to HIV specialist expertise, thereby enhancing comprehensive, team-based care.
  • eConsultation supports the delivery of coordinated and effective care for diverse HIV-related clinical scenarios.