ID-5184 Wonca Abstracts supplement A-K 13-10-23 - Flipbook - Page 305
WONCA 2023 Supplement 1: WONCA 2023 abstracts (A–K)
A
B
C
Implementation of an asynchronous general practitioner-tospecialist eConsult service (eConsultant) in Australia
Dr Jennifer Job1, Caroline Nicholson1, Maria Donald2, Erin Keely3, Clare Liddy4, Prof Claire Jackson1
D
E
F
G
H
I
J
K
Centre for Health System Reform and Integration, Mater Research Institute – University of
Queensland, 2General Practice Clinical Unit, Faculty of Medicine, University of Queensland,
3
University of Ottawa’s Department of Medicine, 4University of Ottawa’s Department of
Family Medicine
1
With rising demand for outpatient services across Australia, patients are experiencing excessive
delays for specialist input, linked with subsequent deterioration in health. Advice-and-Guidance and
eConsult are outpatient substitution models which have been implemented internationally. Based
on the extensively evaluated Canadian Champlain eConsult BASE Service, eConsultant provides an
asynchronous, digital, clinician-to-clinician advice service, giving general practitioners (GPs) remote
access 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 discuss
the eConsultant advice. We studied the implementation of the first Australian eConsultant service
to determine if it would improve access and be more efficient to deliver than a traditional outpatient
service. The main outcomes were time to specialist input and incremental cost saving per patient
from a health system perspective. The cost analysis used a decision analytic model. Qualitative
interviews were conducted with GPs and stakeholders to understand determinants of implementation.
Interview transcripts were coded deductively. Methods were guided by the Consolidated Framework
of 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 for
hospital-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 to
digital infrastructure and reliance on existing referral options. Key facilitators identified were the positive
response 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 will
provide a fundamental change to healthcare delivery in Australia.
303
