Evaluation of BASE eConsult Manitoba: patient perspectives on the use of electronic consultation to improve access to specialty advice in Manitoba

Alexander Singer; Laurie Ireland; Zahra Sepehri; Kelly Brown; Kevin Turner; Clare Liddy; Erin Keely; Luis Oppenheimer

doi:10.1186/s12913-022-08913-3

Evaluation of BASE eConsult Manitoba: patient perspectives on the use of electronic consultation to improve access to specialty advice in Manitoba

BMC Health Serv Res. 2023 Feb 9;23(1):131. doi: 10.1186/s12913-022-08913-3.

Authors

Alexander Singer¹, Laurie Ireland^{2

3}, Zahra Sepehri^{4

5}, Kelly Brown⁶, Kevin Turner⁷, Clare Liddy^{8

9

10}, Erin Keely^{10

11

12}, Luis Oppenheimer¹³

Affiliations

¹ Department of Family Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, D009-780 Bannatyne Ave., MB, Winnipeg, R3E 0W2, Canada. Alexander.singer@umanitoba.ca.
² Department of Family Medicine, University of Manitoba, D009-780 Bannatyne Ave., MB, Winnipeg, R3E 0W2, Canada.
³ Nine Circles Community Health Centre, 705 Broadway Ave. , Winnipeg, MB, R3G 0X2, Canada.
⁴ Department of Internal Medicine, Zabol University of Medical Sciences, Zabol, Iran.
⁵ Department of Family Medicine, Max Rady College of Medicine, University of Manitoba, P219 - 780 Bannatyne Ave, MB, Winnipeg, R3E 0W2, Canada.
⁶ CancerCare, Winnipeg, MB, Canada.
⁷ eConsult Centre of Excellence, University of Manitoba Alumni, Winnipeg, MB, R33 0W2, Canada.
⁸ 7 C.T. Lamont Primary Health Care Research Centre, Bruyere Research Institute, Ottawa, ON, Canada.
⁹ Department of Family Medicine, University of Ottawa, Ottawa, ON, Canada.
¹⁰ eConsult Centre of Excellence, The Ottawa Hospital, Ottawa, ON, Canada.
¹¹ Department of Medicine, University of Ottawa, Ottawa, ON, Canada.
¹² Division of Endocrinology and Metabolism, The Ottawa Hospital, Ottawa, ON, Canada.
¹³ Department of Surgery, University of Manitoba and Winnipeg Regional Health Authority, Winnipeg, MB, Canada.

Abstract

Background: The burden of waiting to access specialist expertise may contribute to poorer health outcomes and causes distress for patients and providers. One solution to improve access to specialist care is to use innovative tools such as remote asynchronous electronic consultation (eConsult). Modeled after the Champlain BASE™ (Building Access to Specialist Advice) eConsult service, BASE™ eConsult Manitoba was launched in 2017 to help address long waits for patients to access specialist advice.

Objective: We aimed to evaluate patients' experiences after obtaining a BASE™ eConsult Manitoba service in their primary care setting.

Methods: Patients whose Primary Care Providers (PCPs) used BASE™ eConsult as part of their care were asked to participate and complete a telephone-based or online 29-question survey between January 2021 and October 2021. The survey questions were created in consultation with patient partners and based on questions asked in studies done in other jurisdictions.

Results: Of the 36 patients who chose to participate, 29 completed the entire survey (80%). Two-thirds (n = 22) agreed that eConsult has been helpful in their situation, and over 80% (n = 24) of participants agreed that eConsult was an acceptable way to access specialist care. During the visit when their PCP sent the eConsult, 7 patients were expecting to be referred to a specialist for a face-to-face consultation. Over half of all respondents (n = 15) reported that before the eConsult occurred, their PCP asked them what questions they wanted to be answered by the specialist. Almost all of these respondents' questions were fully answered by the eConsult. All of the respondents were satisfied with the experience of receiving an eConsult.

Conclusion: Using eConsult is an acceptable way to improve access to specialist advice from patients' perspectives. Consideration should be given to expanding the use of eConsult services to improve access to specialist expertise for PCPs and their patients.

Keywords: Access to care; Primary care; Qualitative research; Quality of care; eConsult.

MeSH terms

Cross-Sectional Studies
Health Services Accessibility
Humans
Manitoba
Medicine*
Referral and Consultation
Remote Consultation*