Objective: To assess the use of eConsults in a Movement Disorders clinic.

Background: The availability of specialized care in most regions is limited and novel ways need to be identified to enhance our care delivery models. In our Movement Disorders clinic, the wait times for new referrals is more than nine months with more than 50 new referral requests per month. eConsults is a web based platform that was designed in Ottawa and now used across the province to enable secure communication between primary care providers (PCPs) and specialists. The expectation is that eConsults are completed in less than a week. PCPs can submit a request to 109 different specialty services, including neurology and in late 2016 a movement disorders subspecialty option was added. Pictures and short videos can be attached to the request and they are now compensated for by the provincial health care plan.

Methods: This is a descriptive study outlining our efforts to promote the use of eConsults. From the referrals on our wait list of less than six months, 320 letters were sent to PCPs outlining this option for care in August 2017. In addition, starting in June 2017 we added the availability of this option to all clinical notes sent back to PCPs and that this platform could be used if they had any questions about their patients being followed in our clinic. Routine utilization data from the service was collected from PCPs.

Results: Only 38 eConsults were generated from June 2017 to February 2018. During this time 553 general neurology consults were performed. Feedback was received for 18 of these with 17/18 feeling they received “good advice for a new or additional course of action”. 6/18 referrals were originally contemplated but now avoided with 5/18 not having felt a consult was needed but wanted assistance with their patient’s care. 17/18 PCPs felt the feedback they received was valuable with the majority also providing written thank you’s.

Conclusions: PCPs who used the eConsult platform almost unanimously felt it provided useful feedback and 1/3 of the time prevented a formal consult request. Unfortunately, despite efforts to promote it’s use, PCPs rarely used this service. Additional study is needed to understand barriers to PCP acceptance and use of this novel technology enabled care platform.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/the-use-of-econsult-in-a-movement-disorders-clinic/