Specialists Triaging Referrals to eConsult: a feasibility study including acceptability and impact of providing advice on primary health care providers
Abstract Background Specialists review referrals for appropriateness and urgency. Limited capacity results in specialists declining referrals leaving primary care providers (PCP), patients, and specialists frustrated. Since specialist availability is unlikely to improve significantly, innovative sol...
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BMC
2025-02-01
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| Online Access: | https://doi.org/10.1186/s12913-025-12346-z |
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| author | Ridha Ali Geetha Mukerji Susan Humphrey-Murto Clare Liddy Heather Lochnan Erin Keely |
| author_facet | Ridha Ali Geetha Mukerji Susan Humphrey-Murto Clare Liddy Heather Lochnan Erin Keely |
| author_sort | Ridha Ali |
| collection | DOAJ |
| description | Abstract Background Specialists review referrals for appropriateness and urgency. Limited capacity results in specialists declining referrals leaving primary care providers (PCP), patients, and specialists frustrated. Since specialist availability is unlikely to improve significantly, innovative solutions are required. This study evaluated the feasibility, acceptability, safety and impact of a new referral triage option Triaging Referrals to eConsult (TReC) which enables specialists to provide advice in lieu of an appointment (advice only) or provide advice to support the PCP until the appointment occurs (advice and appointment). Methods Utilization metrics were prospectively collected (number (%) of referrals converted, time from receipt of referral to completion (response time) and specialist self-reported billing time. To assess PCP opinions on safety (advice was clearly identified and actionable) and acceptability (comfort in patient not seeing a specialist, additional time burden and support for expansion) two surveys, one for those referrals triaged to advice only and another for those triaged to advice and appointment, were faxed 14 days after the referral response. Results From November 1, 2022, to October 31, 2023, five specialties converted 930/16,880 referrals—656 (3.8%) to Advice Only and 274 (1.6%) to Advice and Appointment for an overall conversion rate of 5.5%. 192/1010 (19%) PCPs returned the survey with over 80% agreeing that the advice was easily recognizable, conversion to eConsult was acceptable and the advice was helpful and actionable. Interpretation Enabling specialists to provide advice to PCPs, often in lieu of an appointment, was acceptable, feasible with no major patient safety concerns. |
| format | Article |
| id | doaj-art-ea7167a9bfa24c168cfe49956de6f840 |
| institution | Kabale University |
| issn | 1472-6963 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj-art-ea7167a9bfa24c168cfe49956de6f8402025-02-09T12:26:54ZengBMCBMC Health Services Research1472-69632025-02-012511810.1186/s12913-025-12346-zSpecialists Triaging Referrals to eConsult: a feasibility study including acceptability and impact of providing advice on primary health care providersRidha Ali0Geetha Mukerji1Susan Humphrey-Murto2Clare Liddy3Heather Lochnan4Erin Keely5Department of Medicine, University of OttawaWomen’s College Hospital Institute for Health Systems Solutions and Virtual Care, Women’s College HospitalDepartment of Medicine, University of OttawaDepartment of Family Medicine, Faculty of Medicine, University of OttawaDepartment of Medicine, University of OttawaDepartment of Medicine, University of OttawaAbstract Background Specialists review referrals for appropriateness and urgency. Limited capacity results in specialists declining referrals leaving primary care providers (PCP), patients, and specialists frustrated. Since specialist availability is unlikely to improve significantly, innovative solutions are required. This study evaluated the feasibility, acceptability, safety and impact of a new referral triage option Triaging Referrals to eConsult (TReC) which enables specialists to provide advice in lieu of an appointment (advice only) or provide advice to support the PCP until the appointment occurs (advice and appointment). Methods Utilization metrics were prospectively collected (number (%) of referrals converted, time from receipt of referral to completion (response time) and specialist self-reported billing time. To assess PCP opinions on safety (advice was clearly identified and actionable) and acceptability (comfort in patient not seeing a specialist, additional time burden and support for expansion) two surveys, one for those referrals triaged to advice only and another for those triaged to advice and appointment, were faxed 14 days after the referral response. Results From November 1, 2022, to October 31, 2023, five specialties converted 930/16,880 referrals—656 (3.8%) to Advice Only and 274 (1.6%) to Advice and Appointment for an overall conversion rate of 5.5%. 192/1010 (19%) PCPs returned the survey with over 80% agreeing that the advice was easily recognizable, conversion to eConsult was acceptable and the advice was helpful and actionable. Interpretation Enabling specialists to provide advice to PCPs, often in lieu of an appointment, was acceptable, feasible with no major patient safety concerns.https://doi.org/10.1186/s12913-025-12346-zTriagingReferralsElectronic consultation |
| spellingShingle | Ridha Ali Geetha Mukerji Susan Humphrey-Murto Clare Liddy Heather Lochnan Erin Keely Specialists Triaging Referrals to eConsult: a feasibility study including acceptability and impact of providing advice on primary health care providers BMC Health Services Research Triaging Referrals Electronic consultation |
| title | Specialists Triaging Referrals to eConsult: a feasibility study including acceptability and impact of providing advice on primary health care providers |
| title_full | Specialists Triaging Referrals to eConsult: a feasibility study including acceptability and impact of providing advice on primary health care providers |
| title_fullStr | Specialists Triaging Referrals to eConsult: a feasibility study including acceptability and impact of providing advice on primary health care providers |
| title_full_unstemmed | Specialists Triaging Referrals to eConsult: a feasibility study including acceptability and impact of providing advice on primary health care providers |
| title_short | Specialists Triaging Referrals to eConsult: a feasibility study including acceptability and impact of providing advice on primary health care providers |
| title_sort | specialists triaging referrals to econsult a feasibility study including acceptability and impact of providing advice on primary health care providers |
| topic | Triaging Referrals Electronic consultation |
| url | https://doi.org/10.1186/s12913-025-12346-z |
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