Use of eConsult to enhance genetics service delivery in primary care: A multimethod study.

Genetic Services Health Services Accessibility Humans Ontario Primary Health Care / methods Referral and Consultation Telemedicine / methods
Electronic consultations Genetics Primary care

Journal

Genetics in medicine : official journal of the American College of Medical Genetics
ISSN: 1530-0366
Titre abrégé: Genet Med
Pays: United States
ID NLM: 9815831

Informations de publication

Date de publication:
10 2022
Historique:
received: 03 03 2022
revised: 30 06 2022
accepted: 01 07 2022
pubmed: 11 8 2022
medline: 12 10 2022
entrez: 10 8 2022
Statut: ppublish

Résumé

Electronic consultation (eConsult) is a freely-available secure online platform connecting primary care providers (PCPs) to geneticists. Our purpose was to determine whether eConsult is effective in improving genetics service delivery in primary care. PCP questionnaires regarding eConsult's utility, geneticists' tracking form assessments of eConsult type and appropriateness, and geneticists' interviews on implementing eConsult were carried out. In 2 regions of Ontario, Canada, from January 2019 to June 2020, there were 305 genetics eConsults. For 169 (55%), PCPs indicated receiving good advice for a new course of action; for 110 (36%), referral was now avoided; and for 261 (86%), eConsult was perceived valuable for patient management. Of the 131 geneticist-completed tracking forms, cancer questions were most common (68, 52%). For 63 (48%), geneticists disagreed/strongly disagreed PCPs should know the answer to the referral question. From the interview data, it was observed that geneticists described eConsult positively and suggested how it might improve access and efficiencies if integrated into genetic service delivery. Dealing with eConsults virtually could reduce waitlists, and suggesting appropriate investigations for PCPs could improve efficiencies. eConsult offers a potential solution for receiving timely genetics advice and avoiding unnecessary patient referrals, however, greater effect on access and wait times will need systematic integration into PCP and geneticist practice.

Identifiants

DOI: 10.1016/j.gim.2022.07.003 PMID: 35947109
pubmed: 35947109
pii: S1098-3600(22)00840-1
doi: 10.1016/j.gim.2022.07.003
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

2034-2041

Subventions

Organisme : CIHR
ID : TT7-128272
Pays : Canada

Informations de copyright

Copyright © 2022 American College of Medical Genetics and Genomics. Published by Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Conflict of Interest C.L. and E.K. are cofounders of the Champlain BASE eConsult Service, but they have no commercial interest in the service and do not retain any proprietary rights. As Coexecutive Directors of the Ontario eConsult Centre of Excellence, they receive salary support from the Ontario Ministry of Health. E.K. answers occasional electronic consultations (less than 1 per month) as a specialist through the service for which she is reimbursed. All other authors report no conflicts of interest.

Auteurs

June C Carroll (JC)

Ray D. Wolfe Department of Family Medicine, Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada; Department of Family & Community Medicine, University of Toronto, Ontario, Canada. Electronic address: June.Carroll@sinaihealth.ca.

Clare Liddy (C)

C.T. Lamont Primary Health Care Research Centre, Bruyere Research Institute, Ottawa, Ontario, Canada; Department of Family Medicine, University of Ottawa, Ontario, Canada; Ontario eConsult Centre of Excellence, The Ottawa Hospital, Ottawa, Ontario, Canada.

Amir Afkham (A)

Ontario Health East, Ottawa, Ontario, Canada.

Erin Keely (E)

Ontario eConsult Centre of Excellence, The Ottawa Hospital, Ottawa, Ontario, Canada; Division of Endocrinology & Metabolism, The Ottawa Hospital, Ottawa, Ontario, Canada; Department of Medicine, University of Ottawa, Ontario, Canada.

Elaine S Goh (ES)

Laboratory Medicine and Genetics and Institute for Better Health, Trillium Health Partners, Mississauga, Ontario, Canada; Department of Laboratory Medicine & Pathobiology, University of Toronto, Ontario, Canada.

Gail E Graham (GE)

Department of Pediatrics, University of Ottawa, Ontario, Canada; Department of Genetics, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.

Joanne A Permaul (JA)

Ray D. Wolfe Department of Family Medicine, Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada.

Judith Allanson (J)

Department of Pediatrics, University of Ottawa, Ontario, Canada; Department of Genetics, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.

Ruth Heisey (R)

Department of Family & Community Medicine, University of Toronto, Ontario, Canada; Department of Family and Community Medicine, Women's College Hospital, Toronto, Ontario, Canada.

Tutsirai Makuwaza (T)

Ray D. Wolfe Department of Family Medicine, Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada.

Donna P Manca (DP)

Department of Family Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada.

Mary Ann O'Brien (MA)

Department of Family & Community Medicine, University of Toronto, Ontario, Canada.

Eva Grunfeld (E)

Department of Family & Community Medicine, University of Toronto, Ontario, Canada; Ontario Institute for Cancer Research, Toronto, Ontario, Canada.

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Classifications MeSH

questionsmedicales.fr › Établissements, main d'oeuvre et services de soins de santé › Services de santé › Services de génétique › Use of eConsult to enhance genetics service...
questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Prestations des soins de santé › Accessibilité des services de santé › Use of eConsult to enhance genetics service...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Use of eConsult to enhance genetics service...
questionsmedicales.fr › Régions géographiques › Amériques › Amérique du Nord › Canada › Ontario › Use of eConsult to enhance genetics service...
questionsmedicales.fr › Administration des services de santé › Gestion des soins aux patients › Services de santé polyvalents › Soins de santé primaires › Use of eConsult to enhance genetics service...
questionsmedicales.fr › Administration des services de santé › Organisation et administration › Pratique professionnelle › Orientation vers un spécialiste › Use of eConsult to enhance genetics service...
questionsmedicales.fr › Administration des services de santé › Gestion des soins aux patients › Télémédecine › Use of eConsult to enhance genetics service...