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Gilad Epstein



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  • PS06 - Leveraging Existing Provincial Systems (ID 15)

    • Event: e-Health 2017 Virtual Meeting
    • Type: Panel Session
    • Track: Clinical and Executive
    • Presentations: 1
    • Coordinates: 6/06/2017, 10:30 AM - 12:00 PM, Room 203CD
    • PS06.02 - Increasing Access to Specialty Care with a Provincial eConsult Service (ID 354)

      Gilad Epstein, OTN; TORONTO/CA

      • Abstract
      • Slides

      Purpose/Objectives: The Provincial eConsult Initiative is a program initiated to support the implementation of a provincial eConsult service to enable faster and improved access to specialist care. Three provincial organizations are working together to evaluate existing eConsult services for widespread access and use by physicians and nurse practitioners. The Provincial eConsult Initiative is a complex, multi-faceted project involving technology implementation, business process design and implementation, and the establishment of the program governance framework. This panellist presentation will profile the methodologies leveraged for the provincial initiative, learnings and research from clinical champions, user experiences, and establishment of the service model.

      Methodology/Approach: Utilizing a service development approach that would ensure the long-term success and sustainability of the Provincial eConsult Service was a cornerstone for the initiative. This included establishing a project governance structure and ensuring effective stakeholder engagement and change management strategy in this complex multi-stakeholder initiative. Additionally, a detailed benefits evaluation was conducted under the guidance of the provider advisory group to confirm the clinical value of eConsult. The approach included partnering with other provincial agencies and EMR vendors, leveraging existing assets and offering multiple service models is guided by the clinical leads. From the learnings of the implementation approach, the operating model for service adoption, change management, clinical governance and policies have been defined.

      Finding/Results: Phase 1 was a pilot that generated a Benefits Evaluation to inform a broader provincial strategy. In response to the success of the pilot, the initiative received approval from the ministry to continue with a next phase to March 2017 so that family physicians, nurse practitioners and their patients can continue to benefit from better access to specialist advice. The key accomplishments include: Over 7,000 physicians and nurse practitioners have joined an eConsult service and have sent over 31,900 eConsults to 127 specialties (including sub-specialties and special interests) since the beginning on the initiative in January 2015. A formal benefits evaluation was conducted which found average response times are within 3 days and 99% of clinicians surveyed agree that eConsult improves patient care. Developing a single provincial service that accommodates multiple models of care. Leveraging provincial assets such as single sign on for the Proof of Concept and enabling increased adoption by complimenting clinician workflow through the EMR. Defining a tool-kit and approach to assist clinicians in the change management and adoption of eConsult within their practice.

      Conclusion/Implications/Recommendations: The ongoing use of eConsult demonstrates the continued clinical value and reaffirms the results of the benefits evaluation. Critical elements for the success of a provincial initiative include establishing a robust governance structure, incorporating workflow considerations into adoption strategies, effectively managing delivery partners, and leveraging a standards-based implementation. The panel will share their successful approach and lessons learned, which offers a consideration for other jurisdictions in implementing eHealth initiatives.

      140 Character Summary: Learn about the methodologies used to develop and deliver a complex, multi-faceted Provincial eConsult Initiative.

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