Digital Health

Sending eConsults has never been easier in the Southeast region thanks to SEAMO’s virtual clerk pilot project. In its initial stages in February 2022, this project launched with seven primary care providers (PCPs) from across the region and one clerk to triage eConsults to specialists in Ontario. The project’s process is the virtual eConsult clerk submits the eConsults and retrieves the response on behalf of the PCPs. Currently, the pilot project has expanded to 28 PCPs and added another clerk in operation. 

Dr. Liz Touzel is one of the PCPs who signed on to the pilot project from the beginning and she says this has been “a game changer” for her. “I have always appreciated the tremendous resource of eConsult, but have found the process of signing in to OTN and typing the patient demographics very time-consuming. This pilot project allows me to submit an eConsult in less than a minute, making it feasible to do even on a busy day.” Dr. Touzel is also the PCP who has sent the most eConsults since the pilot project began, and she says this is because it has become “faster and simpler to initiate an eConsult with this project. Having the responses return directly to the patient’s chart also facilitates transmitting the information back to the patient faster.” 

Working with specialists has become easier as well, according to Dr. Touzel. “I have noticed an expanding array of specialists on the list since the inception of the pilot project and many times the information I receive from specialists eliminates the need for a referral. The helpful management advice returns in days rather than the months it can sometimes take to see a specialist,” she explains.

The clerk who has been at the centre of this pilot project is Cindy Boyce and she has successfully managed eConsults for a growing list of PCPs for almost a year now. “I feel this service is a benefit to PCPs as eConsults increase care coordination and accelerate consultation response time to one to seven days. PCPs can start treating their patients instead of patients waiting months for an initial appointment with a specialist,” she describes. “The eConsult service also lets physicians know if a patient should be seen in person. This can increase the provider’s knowledge through specialist responses and reduces referrals to specialists that are not necessary.” 

Boyce says she believes this pilot project “will be an asset to any primary care physician,” adding that she hopes there will become a full-time virtual clerk in the future and many more providers will take advantage of this service for themselves and their patients. “The benefits of eConsult is better access to care for patients, elimination of wait times and efficiency for the PCP. Patients will receive appropriate care sooner,” she says. 

Dr. Jiwei (Josh) Li is a primary care provider based in Kingston who has taken a leadership role in this virtual eConsult clerk pilot project. He explains PCPs are extremely busy and anything that can lessen their workload is worth promoting. “I have to train residents and manage a new practice and complex patients and emails and phone calls and if I had a person that does the back end of the work for team-based care then I don’t have to sign onto another browser and remember the password that changes every day – these are the shortcuts that make a big difference for PCPs.” 

Dr. Li says this pilot project is helping to streamline care every day in the Southeast region. “This makes the day of the PCP easier and obviously there is better patient care when we are running through more eConsults this way. It is about timeliness and effectiveness increased using this project,” he describes. 

In the future, Dr. Li says there are ways of scaling this pilot project. “There’s different ways of growing this project, definitely geographically and definitely with the number of clinics and physicians signed up. If we scale strategically, we can reach regional pooled referrals. If we dedicate more human resources into regional pulled referrals, we can demonstrate when you have a person who manages centralized pulled referrals, it promotes the quintuple aim. Let’s scale so we can have a central rheumatology referral, for example, because that is the goal of integrated care. We’re able to decrease the waiting list for specialist care by promoting pooled referrals.” 

For more information about getting involved in the virtual eConsult clerk pilot project, please contact the SEAMO Digital Health Team.