Division of Orthopaedic Surgery (Hadden, Sakanovic, Meulenkamp), the Ottawa Hospital; The University of Ottawa (Hadden, Sakanovic, Liddy, Keely, Meulenkamp); C.T. Lamont Primary Health Care Research Centre (Guglani, Liddy), Bruyère Research Institute; Departments of Family Medicine (Liddy) and Internal Medicine (Keely), The Ottawa Hospital; The Ottawa Hospital Research Institute (Keely), Ottawa, Ont.
Can J Surg. 2022 Sep 28;65(5):E643-E649. doi: 10.1503/cjs.005820. Print 2022 Sep-Oct.
Increasing strain on public health resources in Canada, in particular with respect to accessing specialist care, necessitates the exploration of alternative models of care. The aim of this study was to assess the efficacy of electronic consultation (eConsult) in providing orthopedic surgery specialist service to patients in the Champlain Local Health Integration Network (LHIN) of Ontario.
This was a cross-sectional review of all 564 Champlain LHIN orthopedic surgery referral requests received via the Champlain Building Access to Specialist service through the eConsult (BASE) system in 2017. Primary outcome measures were impact on primary care provider (PCP) referral pattern and time to receive orthopedic consultation.
eConsult prevented unnecessary in-person consultation 64% of the time, while PCP referral decisions were modified 51% of the time. Of all eConsults, 94% were rated as valuable to PCPs in their practice and 97% of eConsults resulted in actionable advice. eConsults took an average of 14.5 minutes of specialist time to complete, and the mean time from referral to response was 3.7 days.
The eConsult system spares unnecessary consultation to orthopedic surgery; catches important referrals that would have otherwise been missed; saves time for patients, PCPs and orthopedic surgeons; and improves efficiency in a socialized health care system.
加拿大公共卫生资源的压力不断增加，尤其是在获得专科护理方面，因此需要探索替代的护理模式。本研究旨在评估电子咨询（eConsult）在为安大略省尚普兰地方卫生集成网络（LHIN）的患者提供骨科手术专科服务方面的效果。
这是对 2017 年通过 eConsult（BASE）系统接收的尚普兰 LHIN 骨科转诊请求的所有 564 份进行的横断面回顾。主要结果衡量标准是对初级保健提供者（PCP）转诊模式的影响以及接受骨科咨询的时间。
eConsult 阻止了 64%的不必要的当面咨询，同时改变了 51%的 PCP 转诊决定。在所有 eConsults 中，94%的 eConsults 对 PCP 在实践中的工作有价值，97%的 eConsults 提供了可操作的建议。eConsults 平均需要 14.5 分钟的专科时间才能完成，从转诊到回复的平均时间为 3.7 天。
eConsult 系统避免了不必要的骨科手术咨询；发现了否则会错过的重要转诊；为患者、PCP 和骨科医生节省了时间；并提高了在社会化医疗保健系统中的效率。
