Thank you Amir for your responses. For those interested, there is a wealth of great information and analysis in the various articles that are linked to in the presentation slides (provided in our documents section here).

If you do happen to have any further thoughts or questions for Amir and Erin on the subject of eConsult, feel free to post here on the forum, or message me and I can coordinate a follow-up (message Peter here).

I'll be positing details of our next meeting shortly.

Peter had provided us with a few questions after our webinar, and it was suggested they should be posted here for the benefit of anyone else interested in these areas. Below are the questions and responses:

Q1) Using the BASE eConsult systems, your users can choose to append attachments for the specialists to review. Do the PCPs use this feature regularly? Have they expressed any frustrations with not being able to get important data extracted from their EMRs or other sources to pass on the necessary information effectively, or is the open-ended file attachment function cover most cases?

RESPONSE 1: Yes, this capability is used regularly (in nearly 60% of all our cases). Some PCPs have had some “learning” to do to understand existing capabilities in their EMRs to generate an electronic output (similarly to a printer/fax output they would do for traditional consult/referral letters). The overwhelming majority seem to have been able to attach and submit what they need without any issues/frustrations.

Q2) Your findings reported that 40% of the eConsults resulted in avoiding a full referral that was originally contemplated. Have you been able to do any healthcare utilization analysis that might estimate the impacts such as healthcare systems savings and reduction in wait times?

RESPONSE 2: Not yet – but we are collaborating with some other eConsult researchers in other jurisdictions who have done so and demonstrated compelling findings. A publication was expected soon – happy to let you know when it is posted if there is interest.

Q3) You note that a $200/hr remuneration rate has been set, and essentially you are not using the OHIP K738/K739 fee structure for eConsultation. I assume payments are still going through OHIP – has there been special funding established for the pilot alone, or is this a payments structure that is being contemplated province-wide for these services going forward?

RESPONSE 3: The PCP billing code can be used by PCPs initiating eConsults, and some PCPs have been using it regularly (through OHIP). The specialist billing code however is not used for the participants in our service at this point. The specialist participation and remuneration agreements pre-dated the establishment of the OHIP K codes, with specialists self-reporting the billing times per case, and a pro-rated payment being generated for them on a quarterly basis (through The Ottawa Hospital that is the regional lead for this component). This was originally funded by the Champlain LHIN, and the approach has been sustained through the provincial eConsult pilot initiative coordinated through Ontario MD since January 2015 as well. Longer-term province-wide plans are still being evaluated and have not yet been solidified.