Secure physician e-consults expand in Ottawa-area

OTTAWA – A program called eConsult, which enables family physicians in the Ottawa area to contact specialists directly through secure email with questions about patients, has now been expanded to include pediatric specialists.

Dr. Lillian Lai (pictured), a pediatric cardiologist, helped set up the program at the Children’s Hospital of Eastern Ontario. Specialists in 12 fields, including cardiology, chronic pain, oncology and psychiatry have signed up for the program. During a pilot phase that began in February, 400 eConsults were completed and 43 percent of the patients were able to avoid a trip to a specialist.

“What used to take weeks or months for an elective consultation can now be done in minutes, relieving the stress of patient families and physicians, in the community and beyond,” Dr. Lai told the Ottawa Citizen. It has also proven to be an education tool for physicians, “allowing physicians to access insight from specialists and share this new knowledge with their peers.”

The eConsult program was pioneered by Dr. Clare Liddy and endocrinologist Dr. Erin Keely. As a result of the secure e-mail service, many Eastern Ontario patients have been able to get a specialist’s opinion within a few days – some even faster.

“I used to worry about patients I had referred and had no idea what was happening,” said Dr. Liddy, who practices medicine with the Ottawa Hospital Academic Family Health Team. “It was very frustrating.”

The Champlain BASE eConsult service was originally launched in 2010 as a collaborative effort between the Champlain LHIN, Bruyère Research Institute, The Ottawa Hospital, and the Winchester District Memorial Hospital to allow physicians and specialists to communicate directly and securely with each other online.

As of July 1, 2014, over 3400 cases have been processed through this service with response from specialists within 2 days on average. 443 family doctors and nurse practitioners have been registered and can access 48 different specialties.

CHEO’s program is being embraced by families in eastern and northern Ontario who would otherwise have to travel long distances to take their children to see a specialist.

Among doctors who have used the service is Dr. Danielle DeBanné, a family physician who works in Russell, Ont. She has used it frequently for questions she can’t answer herself and she is not sure require a separate visit to a specialist.

“It is wonderful to be able to ask the specialists about a given situation,” she said. Doctors can send lab reports, photographs and other information along with their question. “More often than not,” she said, “the answers are helpful and they prevent a formal visit.”

Typically, family physicians say they might need a specialist’s advice about issues such as identifying a rash. Sending a patient to see a dermatologist – one of the busiest medical specialties – can mean a wait of up to one year for a non-urgent consultation. The eConsultation system could result in an answer within days.

Recently, Dr. Liddy offered advice to health officials in the Los Angeles area who are implementing a similar program.

The BASE service already extends to communities outside the Champaign LHIN, including Sioux Lookout in northern Ontario. Drs. Liddy and Keely have been recognized as innovators by the Ontario Medical Association for the program.

Dr. Lai is looking at expanding the pediatric service to patients on Baffin Island, who are already served by specialists at CHEO and for whom a trip south to see a specialist can be both daunting and costly.

“Better connecting care within and beyond our walls is an important goal for CHEO so we’re excited this technology will allow a family’s doctor and a CHEO specialist to work together as a team to help kids be their healthiest,” says CHEO President and CEO Alex Munter. “This will be a benefit to patients in Ottawa but especially to those in eastern and northern Ontario, allowing families to get an exceptional CHEO patient experience without having to make a trip into the city.”