Connected Medicine Collaboration Results
The Connected Medicine collaboration spread two proven Canadian healthcare innovations that improved access to specialist advice by enabling primary care providers, such as family doctors and nurse practitioners, to ask specialists patient care questions:
- Champlain BASETM (Building Access to Specialists through eConsultation), a secure web-based eConsult service which originated with the Champlain Local Health Integration Network in Ontario
- Rapid Access to Consultative Expertise (RACETM), a telephone advice line and app launched at Providence Health Care and Vancouver Coastal Health.
Results from this collaboration are consistent with those that have been achieved through original implementations of these two innovations. The Connected Medicine collaboration brought about improvements for patients and providers in a number of areas.
Improvements for providers
Primary care providers initiated more than 12,300 remote consults with specialists to support patient care. Teams from Newfoundland and Labrador, New Brunswick, Quebec, Manitoba, Saskatchewan, Alberta, British Columbia and the Department of National Defence enrolled more than 2,200 primary care practitioners and 800 specialists, including many in underserved rural and remote regions.
In some regions, primary care providers had access to as many as 38 specialties for remote consultation. The most commonly available specialty was psychiatry, followed by cardiology, nephrology, obstetrics/gynecology and pediatrics. Four services also offered palliative care consults. Results by team are available in the Results of Collaborative. These practitioners can now access specialist consults through secure digital technology and telephone services.
Improvements for patients
Eligible patients receive care based on specialist advice closer to home, from a primary care provider they know and trust. The process is typically faster than being referred for a face-to-face specialist appointment and often avoids unnecessary trips to the emergency department.
Key facts and figures
- Champlain BASETM currently provides access to 114 specialty groups and 1,000 cases each month in Ontario, with a median response time of 21 hours and nearly two thirds (65 percent) of cases resolved without requiring patients to attend a face-to-face specialist visit1.
- A RACETM data evaluation found that 60 percent of RACE calls appropriately avoided a face-to-face visit with a specialist and 32 percent of calls appropriately avoided hospital ED visits.
- Rapid access to specialist advice: More than four in five eConsults (85 percent) received a response from a specialist within seven days (based on a sample of more than 3,200 eConsults). This work addresses a recognized issue in Canada as identified, for example, in the 2016 Commonwealth Fund Survey – where Canada placed last on a measure of specialist access among the 11 countries surveyed, with 56 percent of the people living in Canada reporting waiting four weeks or longer to see a specialist.
- Care closer to home: More than half of eConsults (53 percent) led to an appropriately avoided face-to-face referral to a specialist, where the primary care provider originally contemplated it but no longer needed to do so based on specialist advice (based on a sample of over 2,600 e-Consults).
- Avoided emergency department visits: Two in five remote consults (42 percent) via phone/app led to an appropriately avoided emergency department (ED) visit, where the primary care provider originally contemplated sending the patient to the ED but the visit was no longer needed based on specialist advice (based on a sample of over 600 phone or mobile app consults).
- To read more about the impact of Champlain BASETM, see: Supporting the spread and scale-up of electronic consultation across Canada: cross-sectional analysis.