Evidence map›Paper›PMID 34906995›Full record

ArticleCMAJ open

Impact of the Connected Medicine collaborative in improving access to specialist care: a cross-sectional analysis.

Clare Liddy, Emma Boulay, Lois Crowe, Maxine Dumas-Pilon, Neil Drimer, Gerard Farrell, Laurie Ireland, Christine Kirby Kirvan, Veronique Nabelsi, Alexander Singer and 2 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in CMAJ open. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Clare LiddyC.T. Lamont Primary Health Care Research Centre, Department of Family Medicine (Liddy, Crowe), Department of Medicine (Keely), University of Ottawa; eConsult Centre of Excellence (Liddy, Keely), The Ottawa Hospital; Bruyère Research Institute (Crowe); Canadian Foundation for Healthcare Improvement (Drimer, Kirvan), Ottawa, Ont.; New Brunswick Medical Society (Boulay), Fredericton, NB; Department of Family Medicine (Dumas-Pilon), McGill University, Montréal, Que.; Department of Family Medicine (Farrell), Memorial University of Newfoundland, St. John's, NL; Nine Circles Community Health Centre (Ireland) and Department of Family Medicine (Singer), University of Manitoba, Winnipeg, Man.; Université du Québec en Outaouais (Nabelsi), Gatineau, Que.; Providence Health Care (Wilson), Vancouver, BC cliddy@uottawa.ca.
Emma BoulayC.T. Lamont Primary Health Care Research Centre, Department of Family Medicine (Liddy, Crowe), Department of Medicine (Keely), University of Ottawa; eConsult Centre of Excellence (Liddy, Keely), The Ottawa Hospital; Bruyère Research Institute (Crowe); Canadian Foundation for Healthcare Improvement (Drimer, Kirvan), Ottawa, Ont.; New Brunswick Medical Society (Boulay), Fredericton, NB; Department of Family Medicine (Dumas-Pilon), McGill University, Montréal, Que.; Department of Family Medicine (Farrell), Memorial University of Newfoundland, St. John's, NL; Nine Circles Community Health Centre (Ireland) and Department of Family Medicine (Singer), University of Manitoba, Winnipeg, Man.; Université du Québec en Outaouais (Nabelsi), Gatineau, Que.; Providence Health Care (Wilson), Vancouver, BC.
Lois CroweC.T. Lamont Primary Health Care Research Centre, Department of Family Medicine (Liddy, Crowe), Department of Medicine (Keely), University of Ottawa; eConsult Centre of Excellence (Liddy, Keely), The Ottawa Hospital; Bruyère Research Institute (Crowe); Canadian Foundation for Healthcare Improvement (Drimer, Kirvan), Ottawa, Ont.; New Brunswick Medical Society (Boulay), Fredericton, NB; Department of Family Medicine (Dumas-Pilon), McGill University, Montréal, Que.; Department of Family Medicine (Farrell), Memorial University of Newfoundland, St. John's, NL; Nine Circles Community Health Centre (Ireland) and Department of Family Medicine (Singer), University of Manitoba, Winnipeg, Man.; Université du Québec en Outaouais (Nabelsi), Gatineau, Que.; Providence Health Care (Wilson), Vancouver, BC.
Maxine Dumas-PilonC.T. Lamont Primary Health Care Research Centre, Department of Family Medicine (Liddy, Crowe), Department of Medicine (Keely), University of Ottawa; eConsult Centre of Excellence (Liddy, Keely), The Ottawa Hospital; Bruyère Research Institute (Crowe); Canadian Foundation for Healthcare Improvement (Drimer, Kirvan), Ottawa, Ont.; New Brunswick Medical Society (Boulay), Fredericton, NB; Department of Family Medicine (Dumas-Pilon), McGill University, Montréal, Que.; Department of Family Medicine (Farrell), Memorial University of Newfoundland, St. John's, NL; Nine Circles Community Health Centre (Ireland) and Department of Family Medicine (Singer), University of Manitoba, Winnipeg, Man.; Université du Québec en Outaouais (Nabelsi), Gatineau, Que.; Providence Health Care (Wilson), Vancouver, BC.
Neil DrimerC.T. Lamont Primary Health Care Research Centre, Department of Family Medicine (Liddy, Crowe), Department of Medicine (Keely), University of Ottawa; eConsult Centre of Excellence (Liddy, Keely), The Ottawa Hospital; Bruyère Research Institute (Crowe); Canadian Foundation for Healthcare Improvement (Drimer, Kirvan), Ottawa, Ont.; New Brunswick Medical Society (Boulay), Fredericton, NB; Department of Family Medicine (Dumas-Pilon), McGill University, Montréal, Que.; Department of Family Medicine (Farrell), Memorial University of Newfoundland, St. John's, NL; Nine Circles Community Health Centre (Ireland) and Department of Family Medicine (Singer), University of Manitoba, Winnipeg, Man.; Université du Québec en Outaouais (Nabelsi), Gatineau, Que.; Providence Health Care (Wilson), Vancouver, BC.
Gerard FarrellC.T. Lamont Primary Health Care Research Centre, Department of Family Medicine (Liddy, Crowe), Department of Medicine (Keely), University of Ottawa; eConsult Centre of Excellence (Liddy, Keely), The Ottawa Hospital; Bruyère Research Institute (Crowe); Canadian Foundation for Healthcare Improvement (Drimer, Kirvan), Ottawa, Ont.; New Brunswick Medical Society (Boulay), Fredericton, NB; Department of Family Medicine (Dumas-Pilon), McGill University, Montréal, Que.; Department of Family Medicine (Farrell), Memorial University of Newfoundland, St. John's, NL; Nine Circles Community Health Centre (Ireland) and Department of Family Medicine (Singer), University of Manitoba, Winnipeg, Man.; Université du Québec en Outaouais (Nabelsi), Gatineau, Que.; Providence Health Care (Wilson), Vancouver, BC.
Laurie IrelandC.T. Lamont Primary Health Care Research Centre, Department of Family Medicine (Liddy, Crowe), Department of Medicine (Keely), University of Ottawa; eConsult Centre of Excellence (Liddy, Keely), The Ottawa Hospital; Bruyère Research Institute (Crowe); Canadian Foundation for Healthcare Improvement (Drimer, Kirvan), Ottawa, Ont.; New Brunswick Medical Society (Boulay), Fredericton, NB; Department of Family Medicine (Dumas-Pilon), McGill University, Montréal, Que.; Department of Family Medicine (Farrell), Memorial University of Newfoundland, St. John's, NL; Nine Circles Community Health Centre (Ireland) and Department of Family Medicine (Singer), University of Manitoba, Winnipeg, Man.; Université du Québec en Outaouais (Nabelsi), Gatineau, Que.; Providence Health Care (Wilson), Vancouver, BC.
Christine Kirby KirvanC.T. Lamont Primary Health Care Research Centre, Department of Family Medicine (Liddy, Crowe), Department of Medicine (Keely), University of Ottawa; eConsult Centre of Excellence (Liddy, Keely), The Ottawa Hospital; Bruyère Research Institute (Crowe); Canadian Foundation for Healthcare Improvement (Drimer, Kirvan), Ottawa, Ont.; New Brunswick Medical Society (Boulay), Fredericton, NB; Department of Family Medicine (Dumas-Pilon), McGill University, Montréal, Que.; Department of Family Medicine (Farrell), Memorial University of Newfoundland, St. John's, NL; Nine Circles Community Health Centre (Ireland) and Department of Family Medicine (Singer), University of Manitoba, Winnipeg, Man.; Université du Québec en Outaouais (Nabelsi), Gatineau, Que.; Providence Health Care (Wilson), Vancouver, BC.
Veronique NabelsiC.T. Lamont Primary Health Care Research Centre, Department of Family Medicine (Liddy, Crowe), Department of Medicine (Keely), University of Ottawa; eConsult Centre of Excellence (Liddy, Keely), The Ottawa Hospital; Bruyère Research Institute (Crowe); Canadian Foundation for Healthcare Improvement (Drimer, Kirvan), Ottawa, Ont.; New Brunswick Medical Society (Boulay), Fredericton, NB; Department of Family Medicine (Dumas-Pilon), McGill University, Montréal, Que.; Department of Family Medicine (Farrell), Memorial University of Newfoundland, St. John's, NL; Nine Circles Community Health Centre (Ireland) and Department of Family Medicine (Singer), University of Manitoba, Winnipeg, Man.; Université du Québec en Outaouais (Nabelsi), Gatineau, Que.; Providence Health Care (Wilson), Vancouver, BC.
Alexander SingerC.T. Lamont Primary Health Care Research Centre, Department of Family Medicine (Liddy, Crowe), Department of Medicine (Keely), University of Ottawa; eConsult Centre of Excellence (Liddy, Keely), The Ottawa Hospital; Bruyère Research Institute (Crowe); Canadian Foundation for Healthcare Improvement (Drimer, Kirvan), Ottawa, Ont.; New Brunswick Medical Society (Boulay), Fredericton, NB; Department of Family Medicine (Dumas-Pilon), McGill University, Montréal, Que.; Department of Family Medicine (Farrell), Memorial University of Newfoundland, St. John's, NL; Nine Circles Community Health Centre (Ireland) and Department of Family Medicine (Singer), University of Manitoba, Winnipeg, Man.; Université du Québec en Outaouais (Nabelsi), Gatineau, Que.; Providence Health Care (Wilson), Vancouver, BC.
Margot WilsonC.T. Lamont Primary Health Care Research Centre, Department of Family Medicine (Liddy, Crowe), Department of Medicine (Keely), University of Ottawa; eConsult Centre of Excellence (Liddy, Keely), The Ottawa Hospital; Bruyère Research Institute (Crowe); Canadian Foundation for Healthcare Improvement (Drimer, Kirvan), Ottawa, Ont.; New Brunswick Medical Society (Boulay), Fredericton, NB; Department of Family Medicine (Dumas-Pilon), McGill University, Montréal, Que.; Department of Family Medicine (Farrell), Memorial University of Newfoundland, St. John's, NL; Nine Circles Community Health Centre (Ireland) and Department of Family Medicine (Singer), University of Manitoba, Winnipeg, Man.; Université du Québec en Outaouais (Nabelsi), Gatineau, Que.; Providence Health Care (Wilson), Vancouver, BC.
Erin KeelyC.T. Lamont Primary Health Care Research Centre, Department of Family Medicine (Liddy, Crowe), Department of Medicine (Keely), University of Ottawa; eConsult Centre of Excellence (Liddy, Keely), The Ottawa Hospital; Bruyère Research Institute (Crowe); Canadian Foundation for Healthcare Improvement (Drimer, Kirvan), Ottawa, Ont.; New Brunswick Medical Society (Boulay), Fredericton, NB; Department of Family Medicine (Dumas-Pilon), McGill University, Montréal, Que.; Department of Family Medicine (Farrell), Memorial University of Newfoundland, St. John's, NL; Nine Circles Community Health Centre (Ireland) and Department of Family Medicine (Singer), University of Manitoba, Winnipeg, Man.; Université du Québec en Outaouais (Nabelsi), Gatineau, Que.; Providence Health Care (Wilson), Vancouver, BC.

Funding

CIHR
6 · The paper itself

Abstract

backgroundIn 2017, the Canadian Foundation for Healthcare Improvement launched the Connected Medicine collaborative to support the implementation, spread and adaptation of 2 innovative remote consult solutions - the Champlain Building Access to Specialists through eConsultation (BASE) eConsult service and the Rapid Access to Consultative Expertise (RACE) service - across Canada. We evaluated the impact of the programs implemented through the collaborative.

methodsWe conducted a cross-sectional analysis of data from provincial teams that participated in the Connected Medicine collaborative, which took place between June 2017 and December 2018 in 7 provinces across Canada (British Columbia, Alberta, Saskatchewan, Manitoba, Quebec, New Brunswick, Newfoundland and Labrador). Data included utilization data collected automatically by the BASE and RACE services and, where available, responses to surveys completed by primary care providers at the end of each case. We assessed programs on the following outcomes: usage (i.e., number of cases completed, average specialist response time), number of specialties available, impact on primary care provider's decision to refer and impact on emergency department visits. We performed descriptive analyses.

resultsTen provincial teams participated in the collaborative and implemented or adapted either the RACE service (4 teams), the BASE service (5 teams) or a combination of the 2 services (1 team). Average monthly case volume per team ranged from 14.7 to 424.5. All programs offered multispecialty access, with specialists from 5 to 37 specialty groups available. Specialists responded to eConsults within 7 days in 80% (

interpretationThe 2 innovative virtual care solutions implemented through the Connected Medicine collaborative received widespread usage and affected primary care providers' decisions to refer patients to specialists. The impact of these models of care in multiple settings shows that they are an effective means to move beyond the pilot stage and achieve spread and scale.

Indexed as

Health PersonnelQuality ImprovementSpecializationAmbulatory CareCanadaClinical Decision-MakingCross-Sectional StudiesEmergency Service, HospitalHealth Services AccessibilityHumansPrimary Health CareReferral and ConsultationSurveys and QuestionnairesTelemedicineTelephone

Identifiers

PMID34906995
PMCPMC8687491

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.