The effect of eConsult on the provision of orthopaedic services in Nunavut

Alenko Sakanovic; William J Hadden; Sheena Guglani; Amir Afkham; Clare Liddy; Erin Keely; Brad Meulenkamp

doi:10.1080/22423982.2022.2151551

The effect of eConsult on the provision of orthopaedic services in Nunavut

Int J Circumpolar Health. 2022 Dec;81(1):2151551. doi: 10.1080/22423982.2022.2151551.

Authors

Alenko Sakanovic¹, William J Hadden¹, Sheena Guglani², Amir Afkham³, Clare Liddy^{2

4}, Erin Keely⁵, Brad Meulenkamp⁶

Affiliations

¹ Division of Orthopaedic Surgery, University of Ottawa, Ottawa, ON, Canada.
² C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, ON, Canada.
³ Enabling Technologies, The Champlain Local Health Integration Network, Ottawa, ON, Canada.
⁴ Department of Family Medicine, University of Ottawa, Ottawa, ON, Canada.
⁵ Department of Medicine University of Ottawa, Ottawa Hospital Research Institute, Ottawa, ON, Canada.
⁶ Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.

Abstract

To assess the effect of eConsultation in providing Orthopaedic Surgery specialist service to patients in Nunavut. A cross-sectional study of 161 Orthopaedic Surgery consultations received from primary care providers (PCPs) in Nunavut via the Champlain Building Access to Specialist service through eConsult (BASE^TM) service over the 2-year period from January 2017 to December 2018. Data captured were: reason for consultation, impact of advice on referral, perceived value to the PCPs and time spent. eConsult avoided unnecessary in-person consultation 62% of the time while catching 5% of the referrals that would have otherwise been missed. PCP referral behaviour was modified 48% of the time. 94% of eConsults were rated as valuable to PCPs in their practice and 100% of eConsults resulted in actionable advice. Further, eConsults took an average of 15.4 minutes of specialist time to complete, and the mean time from referral to response was 1.4 days. eConsultation spares unnecessary consultation to Orthopaedic Surgery, catches important referrals that would have otherwise been missed, decreases wait time, and may reduce cost in remote healthcare systems such as Nunavut.

Keywords: Orthopaedics; consult; referral; remote.

MeSH terms

Cross-Sectional Studies
Humans
Nunavut
Orthopedics*
Referral and Consultation