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J. Joschko

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    OS18 - Minding the Gap in Our Healthcare Policies (ID 34)

    • Event: e-Health 2018 Virtual Meeting
    • Type: Oral Session
    • Track: Clinical Delivery
    • Presentations: 1
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      OS18.02 - Electronic Consultation Services Worldwide: An Environmental Scan (ID 458)

      J. Joschko, C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute; Ottawa/CA

      • Abstract
      • Slides

      Purpose/Objectives: Excessive wait times for specialist care pose a serious concern for many patients, leading to duplication of tests, patient anxiety, and poorer health outcomes. In response to this issue, many healthcare systems have begun implementing technological innovations designed to improve the referral-consultation process. Among these services is electronic consultation (eConsult), which connects primary care providers and specialists via a secure platform to facilitate discussion of patients’ care. In this presentation, we examine the different eConsult services available worldwide and compare the strategies, barriers, and successes of their implementation in different healthcare contexts worldwide.

      Methodology/Approach: We conducted an environmental scan comprised of three stages: a literature review, a grey literature search, and targeted, semi-structured key informant interviews. A team member searched Medline and EMBASE (literature review) and Google (grey literature search) using an established keyword matrix. Upon completing the searches, we generated a list of potential interview candidates from among the stakeholders identified. Potential participants included researchers, care providers, and decision-makers. Maximum variation sampling was employed to ensure sufficient breadth of participant experience. We conducted semi-structured interviews by telephone using an interview guide based on the RE-AIM framework. Analyses of transcripts were conducted using a thematic synthesis approach.

      Finding/Results: A total of 53 services emerged from the published and grey literature. Services spanned 16 countries, with the majority (53%) located in the United States. Hospitals/clinics comprised the most common provider type (34%), while the most common technology platforms utilized were web-based (38%) and electronic medical records (28%). Interviews have been conducted with respondents from various countries and represented a mix of service types (e.g. public versus private, electronic medical record versus web-based). Preliminary analysis has revealed a variety of service structures, payment models, and technologies. Recurring themes include need for physician engagement, importance of maintaining workflow, and value of improving access. Further analysis will be shared during the presentation.

      Conclusion/Implications/Recommendations: eConsult services have emerged in a variety of countries and health system contexts worldwide. Structure, platform, and delivery model varies, but the services consistently demonstrate improved access and high levels of satisfaction.

      140 Character Summary: We conducted an environmental scan of eConsult services available worldwide and compared the strategies, barriers, and successes of their implementation

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