title: Impact of and Satisfaction with a New eConsult Service: A Mixed Methods Study of Primary Care Providers.
abstract: OBJECTIVE
  We have improved access to specialist care and decreased wait times in our region through the development and implementation of the Champlain BASE (Building Access to Specialists through eConsultation) service. This secure, web-based tool allows primary care providers (PCPs) quick access to specialist advice for their patients and often helps to avoid the need for a face-to-face referral. Our successful implementation of eConsult in our region provides a unique opportunity to examine PCPs' satisfaction and overall perspective on using the service.
  
  
  METHODS
  Following the closure of each case, PCPs completed a short survey with multiple-choice and open-ended questions regarding the eConsult. All eConsults submitted between April 15, 2011, and December 31, 2013, were analyzed. We calculated satisfaction scores from the survey and conducted a constant-comparison thematic analysis on those cases where the PCP elected to leave a text response.
  
  
  RESULTS
  We analyzed 2,052 eConsults completed during the study period. In 91% and 93% of eConsults, PCPs reported a high value for their patients and themselves, respectively. In 554 eConsults, PCPs elected to leave a written response. Three major themes emerged: PCP appreciation of the eConsult service, perceived benefits for the quality of patient care, and attitudes towards using a new health technology. High satisfaction was expressed with quick response times, helpfulness of responses, and reassurance reported. Most PCPs felt eConsult had a positive impact on patient care by also providing reassurance to patients, reducing burden of time and travel, and offering educational opportunities to PCPs applicable to future cases.
  
  
  CONCLUSIONS
  PCPs showed a high level of satisfaction with eConsult's quick turnaround time and quality of specialist advice. Our results illustrate the advantages of using asynchronous virtual platforms to increase access to specialty care from a PCP perspective.
authors.affiliation: From the C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, Ontario, Canada (CL, PD, JJ); the Departments of Family Medicine (CL) and Medicine (EK), University of Ottawa, Ottawa, Ontario, Canada; the Champlain Local Health Integration Network, Ottawa, Ontario, Canada (AA); and the Division of Endocrinology/Metabolism, The Ottawa Hospital, Ottawa, Ontario, Canada (EK). cliddy@bruyere.org.
authors.forename: Clare
authors.initials: C
authors.lastname: Liddy
authors.affiliation: From the C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, Ontario, Canada (CL, PD, JJ); the Departments of Family Medicine (CL) and Medicine (EK), University of Ottawa, Ottawa, Ontario, Canada; the Champlain Local Health Integration Network, Ottawa, Ontario, Canada (AA); and the Division of Endocrinology/Metabolism, The Ottawa Hospital, Ottawa, Ontario, Canada (EK).
authors.forename: Amir
authors.initials: A
authors.lastname: Afkham
authors.affiliation: From the C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, Ontario, Canada (CL, PD, JJ); the Departments of Family Medicine (CL) and Medicine (EK), University of Ottawa, Ottawa, Ontario, Canada; the Champlain Local Health Integration Network, Ottawa, Ontario, Canada (AA); and the Division of Endocrinology/Metabolism, The Ottawa Hospital, Ottawa, Ontario, Canada (EK).
authors.forename: Paul
authors.initials: P
authors.lastname: Drosinis
authors.affiliation: From the C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, Ontario, Canada (CL, PD, JJ); the Departments of Family Medicine (CL) and Medicine (EK), University of Ottawa, Ottawa, Ontario, Canada; the Champlain Local Health Integration Network, Ottawa, Ontario, Canada (AA); and the Division of Endocrinology/Metabolism, The Ottawa Hospital, Ottawa, Ontario, Canada (EK).
authors.forename: Justin
authors.initials: J
authors.lastname: Joschko
authors.affiliation: From the C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, Ontario, Canada (CL, PD, JJ); the Departments of Family Medicine (CL) and Medicine (EK), University of Ottawa, Ottawa, Ontario, Canada; the Champlain Local Health Integration Network, Ottawa, Ontario, Canada (AA); and the Division of Endocrinology/Metabolism, The Ottawa Hospital, Ottawa, Ontario, Canada (EK).
authors.forename: Erin
authors.initials: E
authors.lastname: Keely
mesh_terms: D001291:Attitude of Health Personnel; D005260:Female; D006297:Health Services Accessibility / Q000458:organization & administration*; D006801:Humans; D007588:Job Satisfaction; D008297:Male; D008491:Medical Informatics Applications; D009864:Ontario; D011320:Primary Health Care / Q000458:organization & administration*; D011787:Quality of Health Care; D019114:Remote Consultation / Q000379:methods / Q000458:organization & administration*
keywords: Access to Health Care; Health Information Systems; Medical Informatics; Primary Health Care; Specialization