Improving access to specialist care in correctional facilities through Ontario eConsult

Area of Science:

• Health Services Research
• Digital Health
• Correctional Healthcare

Background:

• Primary care providers (PCPs) in correctional facilities face challenges accessing multispecialty medical advice.
• Incarcerated individuals have unique healthcare needs requiring timely specialist input.
• Electronic consultation (eConsult) platforms offer a potential solution to bridge this gap.

Purpose of the Study:

• To assess the accessibility and utility of the Ontario eConsult service for PCPs in federal correctional facilities.
• To evaluate the impact of eConsult on specialist care delivery for incarcerated populations.
• To determine the types of specialty consultations most frequently utilized.

Main Methods:

• A retrospective, cross-sectional, descriptive analysis of eConsults submitted between April 2019 and March 2023.
• Data included 906 completed eConsults from 21 PCPs in federal correctional facilities.
• Analysis focused on specialty distribution, response times, and impact on patient care.

Main Results:

• Cardiology, dermatology, and endocrinology were the most common specialties consulted.
• Median specialist response time was 0.9 days, with a median response time of 15 minutes per case.
• PCPs received actionable advice in 34% of cases, and 81% of cases avoided in-person specialist appointments.

Conclusions:

• The Ontario eConsult service significantly enhances access to multispecialty advice for incarcerated individuals.
• eConsult reduces the necessity for external, in-person specialist visits, thereby decreasing healthcare costs and mitigating security concerns associated with inmate transportation.