title: Unique Educational Opportunities for PCPs and Specialists Arising From Electronic Consultation Services.
abstract: Health care reform should be driven by the goals of better patient experience, improved population health, lower per capita costs, and improved provider satisfaction. Electronic consultation (eConsult) services have been adopted by several jurisdictions in the United States, Canada, and Europe to improve access to specialists by primary care providers (PCPs) and are being heralded as a key component for delivery of coordinated care. The primary intent of an eConsult service is to provide PCPs with efficient, timely, direct access to specialist expertise to help guide the management of their patients, reduce the need for unnecessary face-to-face specialty consultations, and improve the quality of the initial face-to-face consultation when needed, through the preconsultative communication.In addition to improving access to care, eConsult services have been praised by PCPs and specialists for their educational value, in particular their ability to enrich practice-based learning. Less recognized, but equally important from the educational perspective, include the abilities of eConsult programs to promote reflection by PCPs and specialists, improve collegiality and professionalism between primary and specialist care, inform continuing professional development activities and maintenance of certification, and enhance training programs' teaching of effective communication and care coordination.As eConsult services become increasingly available, the medical community must leverage the educational opportunities inherent in eConsult programs to further improve the delivery of coordinated specialty care. The educational role of eConsults should be considered as a priority outcome in their evaluation and must be highlighted and optimized in next iterations of eConsult systems design.
authors.affiliation: E.J. Keely is full professor, Department of Medicine, Faculty of Medicine, University of Ottawa, and chief, Division of Endocrinology and Metabolism, Ottawa Hospital, Ottawa, Ontario, Canada, and specialist lead, Champlain BASE eConsult Service.D. Archibald is assistant professor, Department of Family Medicine, Faculty of Medicine, University of Ottawa, and education researcher, C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, Ontario, Canada.D.S. Tuot is assistant professor, Department of Medicine, University of California, San Francisco; Division of Nephrology, San Francisco General Hospital; and director, San Francisco General Hospital eReferral program and University of California, San Francisco, Center for Innovation in Access and Quality, San Francisco, California.H. Lochnan is associate professor, Department of Medicine, and assistant dean, Continuing Professional Development and Education Programming, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.C. Liddy is associate professor, Department of Family Medicine, Faculty of Medicine, University of Ottawa, clinician investigator, C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, Ontario, Canada, and primary care lead, Champlain BASE eConsult Service.
authors.forename: Erin J
authors.initials: EJ
authors.lastname: Keely
authors.forename: Douglas
authors.initials: D
authors.lastname: Archibald
authors.forename: Delphine S
authors.initials: DS
authors.lastname: Tuot
authors.forename: Heather
authors.initials: H
authors.lastname: Lochnan
authors.forename: Clare
authors.initials: C
authors.lastname: Liddy
mesh_terms: D003142:Communication; D006801:Humans; D008511:Medicine; D011320:Primary Health Care; D012017:Referral and Consultation; D013038:Specialization