Electronic Consultation Systems: Impact on Pediatric Orthopaedic Care

Area of Science:

• Pediatric Orthopaedics
• Health Informatics
• Telemedicine

Background:

• Increasing demand for pediatric orthopaedic surgery consultations leads to extended wait times.
• Electronic consultation services are emerging as a solution to manage increased demand.
• This study evaluates the impact of e-consultations in pediatric orthopaedics within Eastern Ontario, Canada.

Purpose of the Study:

• To assess the effectiveness of pediatric orthopaedic e-consultations.
• To analyze the impact on in-person referrals and consultation times.
• To gauge primary care provider satisfaction with the e-consultation service.

Main Methods:

• A 2-year cross-sectional study of pediatric orthopaedic e-consultations via the BASE eConsult service.
• Analysis of in-person referral reduction, e-consultation response times, and PCP satisfaction.
• Categorization of clinical questions submitted through the e-consultation platform.

Main Results:

• Electronic consultations successfully avoided 68% of potential in-person appointments.
• Median specialist response time to primary care providers (PCPs) was under 20 hours.
• 69% of consultations involved multiple clinical questions, primarily concerning trauma and fracture management.

Conclusions:

• Pediatric orthopaedic e-consultations are effective and timely, significantly reducing the need for in-person visits.
• Primary care providers reported high satisfaction (97% good or excellent) with the service's value.
• Further research is needed to explore the broader impact of e-consultations on patient care quality and population health.