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Mona Mattei

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  • OS04 - Mind the Access to Care Gaps (ID 4)

    • Event: e-Health 2017 Virtual Meeting
    • Type: Oral Session
    • Track: Clinical
    • Presentations: 1
    • Coordinates: 6/05/2017, 04:00 PM - 05:30 PM, Room 202CD
    • OS04.06 - Rural Communities Have e-ASE of Access to Specialists (ID 176)

      Mona Mattei, Kootenay Boundary Divison of Family Practice; Grand Forks/CA

      • Abstract
      • Slides

      Purpose/Objectives: This session presents e-ASE, a suite of electronic services that provides primary care teams in rural BC with access to specialist colleagues for timely assistance with patient management. E-ASE incorporates telephone, video and secure texting connectivity, with future e-Consult capabilities planned within a secure environment. Patients living in rural or remote areas are at increased risk of poor health outcomes than their urban counterparts. Some of these poor outcome may be due to limited access to specialists. Reduced access may be as a result of • small numbers of specialists available in rural and remote areas • the high costs of travel and road safety concerns when attending specialist appointments In rural areas, patients often travel to see health care providers in communities other than their own. Many patients choose not to access care services, delay accessing care or do so sporadically. In a 2016 patient survey 25% of patients surveyed either delayed or refused care if travel was required. Communications between providers in this setting is complex or delayed, potentially resulting in a lack of clarity between providers about patient care. Central to the support of patients in rural areas is access to specialist care either directly or through their primary care team. In partnership with Interior Health Authority of BC, Shared Care with the Kootenay Boundary Division of Family Practice, and Specialists Services Committee, Doctors of BC, e-ASE provides multiple points of access to specialist support in the Kootenay Boundary region of BC.

      Methodology/Approach: e-ASE offers a suite of electronic capabilities connecting primary care teams to specialist colleagues for timely collaborative patient care planning. It improves quality of care in remote sites by linking rural clinicians and patients to the central clinical hubs. The various communication modalities and embedded patient data allow specialists to prioritize response and include primary care providers in all aspects of care planning. There are three active clinical programs for telehealth: Mobile Maternity (MoM), critical care link and in-clinic video conferencing. MoM uses mobile devices (tablets and phones) for obstetric consultations prioritizing tripartite care planning model with FPs, NPs and midwives. In-Clinic software installed in rural family physician’s exam rooms provides consults with specialists in urban centers. Similar technology enables an early connection between critically ill patients in remote emergency departments and the regional Intensive Care Unit providing faster access and implementation of time sensitive critical treatments. Secure texting is delivered using an adaptation of a system successfully implemented in the urban centre of Kelowna. The system provides: · on-call schedules identifying specialists available; · instant messaging to connect with specialists providing return contact information; · ability to provide detailed patient information including photos, labs and x-rays; · linkage to the hospital EHR to provide ADT notification on patients.

      Finding/Results: Messaging cuts down call volume, saves time and makes patient care more efficient. Kelowna has experienced improvements in physician and nurse satisfaction, quality of communications and time savings.

      Conclusion/Implications/Recommendations: The team will present emerging data and provide an opportunity for facilitated discussion on goals and outcomes.

      140 Character Summary: e-ASE, a new suite of electronic services connects primary care teams in rural BC with specialist colleagues for timely assistance with patient management.

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