Electronic consultations improve primary care physicians' access to subspecialty advice and reduce patient referrals

A new study in the Annals of Family Medicine examines usage data from a provincial electronic consultation (eConsult) service in Ontario, Canada, which facilitates rapid and secure communications between primary care physicians and subspecialists. The research team sought to analyze eConsult's impact on primary care physicians' access to subspecialty advice, health system costs, and whether there was a decreased need for in-person visits. They also identified barriers to access and uptake over a two-year period.

Study participants submitted 60,474 eConsult records during the study period. Uptake in eConsult usage increased significantly month over month, from 1,487 eConsults in July 2018 to 4,179 in June 2020. The median subspecialist response time was one day, with a billed median of 15 minutes per case, which resulted in a median cost of $50. Requesting physicians received advice for a new or additional course of action in 55% of cases and received confirmation on their original course of action in 40%. In 51% of cases, a referral was avoided because of the eConsult.

The researchers state these findings are comparable to the average subspecialist response time of other eConsult services across Canada, suggesting that eConsult is highly generalizable and can be scaled up without sacrificing effectiveness. The findings suggest that eConsult can also reduce unnecessary specialty referrals, saving the patient and health system time and money.