Experiences of specialist physicians with e-consultations

Area of Science:

• Health Informatics
• Telemedicine
• Physician Communication

Background:

• Newfoundland and Labrador (NL) implemented a province-wide e-consult service in 2018.
• E-consultations facilitate asynchronous virtual communication between primary care providers (PCPs) and specialists via electronic health records (EHRs).
• The service aims to enhance communication and expedite access to specialized medical care.

Purpose of the Study:

• To investigate the experiences of specialists using the NL e-consult system.
• To identify facilitators and barriers to the effective use of e-consultations.

Main Methods:

• An observational study employing a mixed-methods approach.
• An anonymous, web-based questionnaire distributed to specialists participating in the NL e-consult service (January 2018 - December 2022).

Main Results:

• A 55% response rate (36/66) was achieved, with internal medicine specialists forming the largest group (53%).
• While most specialists recognized the value of e-consults, 90% lacked protected clinical time, and 92% reported completing them outside regular working hours.
• Time spent weekly varied (≤1 hour: 47%; 2-3 hours: 30%), and only 44% received financial reimbursement.

Conclusions:

• The NL e-consult system has been successfully integrated into the provincial healthcare framework.
• Challenges related to dedicated time allocation and financial compensation require attention for the system's sustained viability.