Ontario Primary Care Practitioners and Access to Ophthalmologists Through Electronic Consultation.

Purpose: In Canada, accessing specialty services remains a significant challenge, leading to growing wait times for specialist care. To address this concern, the Champlain Building Access to Specialists through eConsultation (BASE) service was introduced. The Champlain BASE eConsult service is a secure web-based program that enables access to medical specialists by PCPs. The primary objective is to investigate the types of questions primary care providers (PCP) are asking ophthalmologists through the BASE service. Patients and Methods: Descriptive and retrospective analysis of 116 eConsults sent from PCPs to the ophthalmology specialty between January and December 2022, within the Champlain region, covering ~ 1.3 million people in Eastern Ontario. Using two validated taxonomies, the "content" and "type" of questions asked were coded. A closeout survey was used to determine PCP's subsequent course of action, referral outcomes, and perceived helpfulness of eConsult responses. Results: 116 eConsults (37 pediatric; 79 adult) were reviewed with an average patient age of 36.8 years. The most common types of questions asked related to general management (61%) and referral appropriateness (43%). The most common content questions related to other non-specified content - adults (28%), lid lesions (24%) and other non-specified content - pediatrics (12%). The ophthalmologist's median response time was 0.67 days (16.1 hours) after eConsult creation, with 84% of responses being received within seven days. PCPs received a new or additional course of action in 47% of cases. Unnecessary in-person referrals were avoided in 44% of cases. Over 88% of cases were rated at least 4/5 in value, and in 94% of eConsults, the ophthalmologists' recommendations were accepted. Conclusion: The use of the eConsult service improves access to ophthalmologists by providing quicker, helpful, and generally accepted specialist advice while decreasing the requirement for patients to attend in-person consultations.