Liddy Clare, Afkham Amir, Drosinis Paul, Joschko Justin, Keely Erin
From the C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, Ontario, Canada (CL, PD, JJ); the Departments of Family Medicine (CL) and Medicine (EK), University of Ottawa, Ottawa, Ontario, Canada; the Champlain Local Health Integration Network, Ottawa, Ontario, Canada (AA); and the Division of Endocrinology/Metabolism, The Ottawa Hospital, Ottawa, Ontario, Canada (EK).
J Am Board Fam Med. 2015 May-Jun;28(3):394-403. doi: 10.3122/jabfm.2015.03.140255.
We have improved access to specialist care and decreased wait times in our region through the development and implementation of the Champlain BASE (Building Access to Specialists through eConsultation) service. This secure, web-based tool allows primary care providers (PCPs) quick access to specialist advice for their patients and often helps to avoid the need for a face-to-face referral. Our successful implementation of eConsult in our region provides a unique opportunity to examine PCPs' satisfaction and overall perspective on using the service.
Following the closure of each case, PCPs completed a short survey with multiple-choice and open-ended questions regarding the eConsult. All eConsults submitted between April 15, 2011, and December 31, 2013, were analyzed. We calculated satisfaction scores from the survey and conducted a constant-comparison thematic analysis on those cases where the PCP elected to leave a text response.
We analyzed 2,052 eConsults completed during the study period. In 91% and 93% of eConsults, PCPs reported a high value for their patients and themselves, respectively. In 554 eConsults, PCPs elected to leave a written response. Three major themes emerged: PCP appreciation of the eConsult service, perceived benefits for the quality of patient care, and attitudes towards using a new health technology. High satisfaction was expressed with quick response times, helpfulness of responses, and reassurance reported. Most PCPs felt eConsult had a positive impact on patient care by also providing reassurance to patients, reducing burden of time and travel, and offering educational opportunities to PCPs applicable to future cases.
PCPs showed a high level of satisfaction with eConsult's quick turnaround time and quality of specialist advice. Our results illustrate the advantages of using asynchronous virtual platforms to increase access to specialty care from a PCP perspective.
我们通过开发和实施尚普兰BASE(通过电子会诊建立专家诊疗通道)服务,改善了本地区专科护理的可及性并缩短了等待时间。这个安全的基于网络的工具使初级保健提供者(PCP)能够快速为其患者获取专家建议,并且常常有助于避免面对面转诊的需要。我们在本地区成功实施电子会诊,为研究PCP对使用该服务的满意度和总体看法提供了独特的机会。
在每个病例结束后,PCP完成一份关于电子会诊的包含多项选择题和开放式问题的简短调查问卷。对2011年4月15日至2013年12月31日期间提交的所有电子会诊进行了分析。我们根据调查问卷计算满意度得分,并对PCP选择留下文本回复的那些病例进行了持续比较主题分析。
我们分析了研究期间完成的2052次电子会诊。在91%和93%的电子会诊中,PCP分别报告该服务对其患者和自身具有很高价值。在554次电子会诊中,PCP选择留下书面回复。出现了三个主要主题:PCP对电子会诊服务的赞赏、对患者护理质量的感知益处以及对使用新健康技术的态度。PCP对快速回复时间、回复的帮助性以及所提供的安心感表示高度满意。大多数PCP认为电子会诊对患者护理有积极影响,还为患者提供了安心感,减轻了时间和出行负担,并为PCP提供了适用于未来病例的教育机会。
PCP对电子会诊的快速周转时间和专家建议质量表示高度满意。我们的结果从PCP的角度说明了使用异步虚拟平台增加专科护理可及性的优势。