WONCA 2023 Supplement 1: WONCA 2023 abstracts (A–K)ABCImplementation of an asynchronous general practitioner-tospecialist eConsult service (eConsultant) in AustraliaDr Jennifer Job1, Caroline Nicholson1, Maria Donald2, Erin Keely3, Clare Liddy4, Prof Claire Jackson1DEFGHIJKCentre for Health System Reform and Integration, Mater Research Institute – University ofQueensland, 2General Practice Clinical Unit, Faculty of Medicine, University of Queensland,3University of Ottawa’s Department of Medicine, 4University of Ottawa’s Department ofFamily Medicine1With rising demand for outpatient services across Australia, patients are experiencing excessivedelays for specialist input, linked with subsequent deterioration in health. Advice-and-Guidance andeConsult are outpatient substitution models which have been implemented internationally. Basedon the extensively evaluated Canadian Champlain eConsult BASE Service, eConsultant provides anasynchronous, digital, clinician-to-clinician advice service, giving general practitioners (GPs) remoteaccess to specialist support for patient care within three business days. GPs send a request for advice(RFA) to the specialist and advise patients to schedule a timely follow-up appointment to discussthe eConsultant advice. We studied the implementation of the first Australian eConsultant serviceto determine if it would improve access and be more efficient to deliver than a traditional outpatientservice. The main outcomes were time to specialist input and incremental cost saving per patientfrom a health system perspective. The cost analysis used a decision analytic model. Qualitativeinterviews were conducted with GPs and stakeholders to understand determinants of implementation.Interview transcripts were coded deductively. Methods were guided by the Consolidated Frameworkof Implementation Research.RFAs have been generated for 191 patients (mean age 60 years) from 63 GPs in 22 general practices.The mean specialist response time was 1.7 days (SD 2.3) and patients’ mean time to specialist input(initial GP to GP follow-up appointment) was 13.0 days (SD 2.7), well below average waiting times forhospital-based appointments. eConsultant is associated with an efficiency gain of $361.07 per patient.Qualitative interviews with 11 GPs/four stakeholders identified implementation barriers related todigital infrastructure and reliance on existing referral options. Key facilitators identified were the positiveresponse from patients to the program and the relative advantage of eConsultant over other options.This research supports broader implementation of the international eConsultant model, which willprovide a fundamental change to healthcare delivery in Australia.303
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