Specialists

Specialists

Participating in eConsult has many benefits:

  • To reduce the amount of time patients have to wait for specialist advice
  • To reduce the number of unnecessary referrals received
  • To reduce the number of unnecessary face-to-face visits conducted
  • To reduce patient wait times for specialists
  • To help PCPs better prepare patients for specialist appointments by ensuring all necessary imaging, lab work, etc., is completed prior to the initial visit
  • To enhance communication between PCPs and specialists

It should also be noted that, unlike a “hallway consultation” between physicians, specialists participating in eConsult are compensated for providing an eConsult. This also allows for an audit trail of the consultation having occurred.

Specialists enrolled with the Ontario eConsult Service are expected to:

  • Be experienced healthcare practitioners in good standing with their regulatory body
  • Respond to requesting provider questions within 7 days (median response time is 2 days)
  • Have a desire to improve equitable access to care
  • Have an interest in providing collegial, educational replies
  • Contribute to a community of practice with physicians and nurse practitioners in South East region

Who else is participating in the eConsult Service?

How do I join the eConsult Service?

FAQs

What is an eConsult?

An eConsult is an electronic communication between a primary care provider (PCP) and a specialist. The PCP sends a patient-specific medical question to the specialist via a secure, web-based platform. They can also attach pertinent documents, such as imaging, lab results, etc., if required. The specialist can then respond with timely advice without the need for a face-to-face consultation. For more information on how an eConsult work, visit the Ontario eConsult Service’s website

Who is involved?

The Ontario Telemedicine Network (OTN) provides the technological infrastructure for the eConsult Service, leveraging the Champlain BASE Model. OntarioMD provides some primary care support and EMR integration. SEAMO oversees the registration process, produces reports for key stakeholders and provides funding to specialists participating in the eConsult Service.

Approximately 50% of primary care providers in the South East Region participate in the Ontario eConsult Service, including the Queen’s Family Health Team.  All primary care providers, physicians and nurse practitioners, are strongly encouraged to become involved in the eConsult Service. 

Specialists with an interest in telemedicine, innovative patient care and a willingness to champion eConsults among their peers, are encouraged to speak to their department heads about joining the eConsult Service. 

Over 90 specialties and sub-specialties are available through the eConsult Service. PCPs can access both regional and provincial specialists through the BASE Managed Groups and Direct-to-Specialist options.
 

How has the Ontario eConsult Service impacted referrals?

Early data from Phase 1 of the SEAMO eConsult Pilot Project (Feb. 1 to Jun. 15, 2017) showed a 40% reduction in the number of face-to-face consultations in cases where a referral was originally considered but was avoided.

In 18% of cases, a referral was not originally contemplated, and was still not needed, but an eConsult provided useful feedback and/or information.

In 32% of cases, a referral was initially contemplated, and was needed, but an eConsult likely led to a more effective specialist visit.

Why should I participate?

For Patients

  • Care supported by a service that is fast, efficient, private, safe and cost-effective
  • All patients receive access to quality specialist advice quickly, wherever they live in Ontario
  • Only about one-third of eConsults result in patients needing to see a specialist face-to-face. 
  • Evidence shows patient safety is improved through timely access to specialist advice.

For Physicians and Nurse Practitioners

  • Provides timely access to non-urgent questions (average response time 2 days)
  • Access to over 90 specialties & sub-specialties
  • Improved care coordination and collaboration between clinicians
  • Provides opportunities to enhance learning and manage patient cases at the family practice level, where patient trust is often highest

For Specialists

  • Allows prompt, high-quality communication with requesting providers 
  • Provides opportunities for knowledge sharing and increased capacity in primary care
  • Is an important part of restructuring care to improve equitable access for patients

It should also be noted that, unlike a “hallway consultation” between physicians, specialists participating in the service are compensated for providing an eConsult. This also allows for an audit trail of the consultation having occurred.
 

How will I be compensated?

Specialists participating in the Ontario eConsult Service are paid by SEAMO on a quarterly basis. Time spent on an eConsult is self-reported, and is paid at $200/hour, pro-rated in 5-minute increments, rounded up to the nearest increment, for the first 25 minutes. Time spent after 25 minutes is pro-rated to the minute. The maximum billing time per eConsult response is 60 minutes. If an eConsult lasts more than 20 minutes, the system prompts the specialist for an explanation, in order to be compensated for the portion of the consult over 20 minutes.

How long will it take me to complete an eConsult?

The length of time it takes to complete an eConsult depends on the complexity of the question from the requester.

In the South East Region, the median time spent on an eConsult is 15 minutes. 
 

How many eConsults do I have to complete?

There is no set number of eConsults each participant must complete. Specialists have the ability to set a weekly maximum number of cases they would like to answer.

How fast do I have to respond to a request for an eConsult?

eConsults must be answered by specialists within 7 days.

How do I register for the Ontario eConsult Service?

You can sign up on our website.

What if my specialty is not part of SEAMO?

If your specialty is not part of SEAMO, please contact the Digital Health Support Team by email or phone 613-533-6000 ext. 75963.

Can Allied Healthcare colleagues participate?

A pilot project for Optometry is ongoing until March 2020. For information, please contact the Digital Health Support Team

Otherwise, only physicians and nurse practitioners are currently able to participate in the eConsult Service.

What is the Canadian Medical Protective Association's (CMPA) position on physicians using eConsults to provide patient care?

The Canadian Medical Protective Association has assessed the eConsult flow of care and determined that it provides an opportunity to improve efficiency, enhance care, improve access to specialists, and provides a clear audit trail of advice given to primary care providers by specialists.

Who is the most responsible physician (MRP) during an eConsult?

According to the Canadian Medical Protective Association, the primary care provider remains the MRP for the patient when using the eConsult Service. When a specialist accepts an eConsult, the responsibility of care or decision-making does not transfer to the specialist.

What are the liability considerations for specialists?

According to the Canadian Medical Protective Association, specialists are accountable for any advice given via eConsult for patient care, similar to any advice given to a primary care provider during a “hallway consultation”. Unlike a “hallway consultation”, however, an eConsult provides a clear audit trail, linking the specialist advice to the primary care provider, which is also documented in the patient’s medical record.

What are the technical requirements for using eConsult?

Full details of the technical requirements for the Ontario eConsult Service can be found on the OTN Hub

Which browsers are compatible with the OTN Hub?

The OTN Hub is cloud-based and is compatible with the following browsers:

  • Safari v8+
  • Firefox v38+
  • Google Chrome v42+

Full details of the technical requirements for the Ontario eConsult Service can be viewed on the OTN Hub.
 

I forgot my ONE®ID username or password

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Your ONE®ID username is firstname.lastname@oneid.on.ca

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Self-serve password reset is available for ONE®ID on the login screen by clicking on the "Forgot Password?" tab. If this does not resolve your issue, please contact the eHealth Ontario help desk at 1-866-250-1554.
 

I'm unable to submit or answer a query using the eConsult website

If you are experiencing technical issues with the eConsult platform, please contact the Ontario Telemedicine Network (OTN) Customer Care Centre at 1-866-454-6861. 

If your issue can't be resolved, please contact the SEAMO Digital Health Team at 613-533-6000 ext. 75963.
 

I can't connect to the eConsult website

If you are unable to connect to the eConsult website, first determine if the problem is with your browser, Wifi or Internet connection.

If you are attempting to connect from Queen's University, contact the IT Support Centre at 613-533-6666 (internal ext. 36666).

If you are attempting to connect from Kingston General Hospital or Hotel Dieu Hospital sites, contact the KHSC IT Help Desk at 613-549-6666 ext. 4357 or by email.

If you are attempting to connect from home, please contact your Internet Service Provider.

If you are experiencing technical issues with the eConsult platform itself, please contact the Ontario Telemedicine Network (OTN) Customer Care Centre at 1-866-454-6861. 

If your issue can't be resolved, please contact the SEAMO Digital Health Team at 613-533-6000 ext. 75963.
 

I have a different technical problem

If you have a different technical problem related to the Ontario eConsult Service, please contact the SEAMO Digital Health Support Team at 613-533-6000 ext. 75963

Can eConsults be conducted from outside Ontario?

The Ministry of Health has stated that physicians cannot submit or respond to eConsults while outside Ontario.

How do I indicate I'm unavailable for consults?

After logging in to the OTNhub eConsult platform, click on Settings. Under Availability, click on Unavailable Dates to choose your start and end dates. 

SEAMO's Digital Health Support Team can also set availability on a specialist’s behalf. Please contact the Digital Health Support Team by phone (613-533-6000 ext. 74214) or by email.

Where do I find more information on the Ontario eConsult Service?

If you would like to participate in the Ontario eConsult Service, please download a registration form and email the completed version to the SEAMO Digital Health Support Team.

You can also visit the Ontario eConsult Service website for more information.