OTTAWA, July 18, 2019 /CNW/ - The Canadian Foundation for Healthcare Improvement (CFHI), in partnership with Canada Health Infoway, the College of Family Physicians of Canada and the Royal College of Physicians and Surgeons of Canada, is announcing the successful expansion of provider-to-provider remote consult services, improving patient access to specialist advice in primary care in seven provinces.

Through the 18-month Connected Medicine: Enhancing Primary Access to Specialist Consult collaboration, primary care providers initiated more than 12,300 remote consults with specialists to support patient care. Teams from Newfoundland and Labrador, New Brunswick, Quebec, Manitoba, Saskatchewan, Alberta, British Columbia, and the Department of National Defense, enrolled more than 2,200 primary care practitioners and 800 specialists, including many in underserved rural and remote regions.

These practitioners can now access specialist consults through secure digital technology and telephone services. The result is that eligible patients get care based on specialist advice closer to home, by a primary care provider they know and trust. The process is typically faster than being referred for a face-to-face specialist appointment and often avoids unnecessary trips to the emergency department.

Connected Medicine Results:

• Rapid access to specialist advice: More than 4 in 5 eConsults (85 percent) received a response from a specialist within 7 days (based on a sample of more than 3,200 eConsults). This work addresses a recognized issue in Canada, for example, as identified in the 2016 Commonwealth Fund Survey, where Canada placed last on a measure of specialist access among the 11 countries surveyed, with 56 percent of Canadians reporting waiting four weeks or longer to see a specialist.
• Care Closer to Home: More than half of eConsults (53 percent) led to an appropriately avoided face-to-face referral to a specialist, where one was originally contemplated but no longer needed based on specialist advice (based on a sample of over 2,600 e-consults).
• Avoided ED Visits: 2 in 5 remote consults (42 percent) via phone/app led to an appropriately avoided emergency department (ED) visit, where the primary care provider originally contemplated sending the patient to the ED but the visit was no longer needed based on specialist advice (based on a sample of over 600 phone or mobile app consults).

Participating teams are at different stages in their individual implementation given varying program launch dates, program scope, local needs, and provider availability. In some regions, as many as 38 specialties were made available for remote consultation with primary care providers. The most commonly available specialty was psychiatry. Cardiology, nephrology, obstetrics/gynecology and pediatrics were the next most frequently offered specialties. Four services also offered palliative care consults. Results by Team, including highlights, are available in the Backgrounder.

The collaboration spread two proven Canadian healthcare innovations that improve access to specialist advice by allowing primary care providers, such as family doctors and nurse practitioners, to ask specialists patient care questions:

• Champlain BASETM (Building Access to Specialists through eConsultation), a secure web-based eConsult service which originated with the Champlain Local Health Integration Network in Ontario, and
• Rapid Access to Consultative Expertise (RACETM), a telephone advice line and app launched at Providence Health Care and Vancouver Coastal Health.

Results from this collaboration are consistent with those that have been achieved through original implementations of these two innovations. Champlain BASETM currently provides access to 114 specialty groups and 1,000 cases each month in Ontario, with a median response time of 21 hours and nearly two thirds (65 percent) of cases resolved without requiring patients to attend a face-to-face specialist visit. An evaluation of data from RACETM found that 60 percent of RACE calls appropriately avoided a face-to-face visit with a specialist and 32 percent of calls appropriately avoided hospital emergency department visits.