Evidence map›Paper›PMID 35451985›Full record

ArticleJMIR formative research2022

The Ontario Electronic Consultation (eConsult) Service: Cross-sectional Analysis of Utilization Data for 2 Models.

Sheena Guglani, Clare Liddy, Amir Afkham, Rhea Mitchell, Erin Keely

Abstract read
In one paragraph

Article in JMIR formative research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–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

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. 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

5 authors.

Sheena GuglaniC.T. Lamont Primary Health Care Research Centre, Bruyere Research Institute, Ottawa, ON, Canada.ORCID https://orcid.org/0000-0002-6968-2463
Clare LiddyC.T. Lamont Primary Health Care Research Centre, Bruyere Research Institute, Ottawa, ON, Canada.ORCID https://orcid.org/0000-0003-0699-5494
Amir AfkhamOntario Health East, Ottawa, ON, Canada.ORCID https://orcid.org/0000-0001-7563-636X
Rhea MitchelleConsult Centre of Excellence, The Ottawa Hospital, Ottawa, ON, Canada.ORCID https://orcid.org/0000-0003-4693-8232
Erin KeelyeConsult Centre of Excellence, The Ottawa Hospital, Ottawa, ON, Canada.ORCID https://orcid.org/0000-0002-3407-5065

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe Ontario electronic consultation (eConsult) service allows a primary care provider (PCP) to access specialist advice through 2 models: the direct-to-specialist (DTS) model, where PCPs select a specialist from a directory, and the Building Access to Specialists Through eConsultation (BASE)-managed specialty service, where PCPs choose a specialty group and are assigned a specialist from a qualified pool based on availability.

objectiveThe aim of this study is to examine patterns of use between the 2 models of eConsult delivery.

methodsWe conducted a cross-sectional analysis of utilization data collected from eConsults completed between October 2018 and September 2019. Cases were grouped based on the model used for submission (ie, BASE or DTS). Each model was assessed for the number of cases over time, specialty distribution, proportion resulting in new or additional information, impact on PCPs' decisions to refer, and billing time.

resultsPCPs submitted 26,121 eConsults during the study period. The monthly case volume increased by 43% over the duration of the study, primarily in the BASE model (66% compared to 6% for DTS). PCPs were able to confirm a course of action that they originally had in mind in 41.4% (6373/15,376) of BASE cases and 41.3% (3363/8136) of DTS cases and received advice for a new or additional course of action in 54.7% (8418/15,376) of BASE cases and 56.3% (4582/8136) of DTS cases. A referral was originally contemplated but avoided in 51.3% (7887/15,376) of BASE cases and 53.3% (4336/8136) of DTS cases, originally contemplated and still needed in 19.4% (2986/15,376) of BASE cases and 17.7% (1438/8136) of DTS cases, and neither originally contemplated nor needed in 21.7% (3334/15,376) of BASE cases and 21.9% (1781/8136) of DTS cases.

conclusionsBoth eConsult models had strong uptake. Use patterns varied between models, with the majority of growth occurring under BASE, but survey responses showed that both models provided similar outcomes in terms of new information offered and impact on decision to refer.

Indexed as

access to careconsultationdirect-to-specialisteConsulthealthcare systemOntarioprimary care providerutilization

Identifiers

PMID35451985
PMCPMC9077515

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Registered trials

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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.