Dialogue Volume 15, Issue 3 2019 - Page 47

PRACTICE PARTNER eConsult Allows Doctors to Tap into Prompt Advice from Specialists D Dr. Clare Liddy r. Sarah Newbery’s teenage patient was presenting with a shoulder issue that the Marathon family physician had never previously encountered. "She had limited range of motion, and a scapular crepitus that I had not seen – or heard – previously," remembers Dr. Newbery. The wait for the patient to see a pediatric orthopedic surgeon – a service that is not available locally and is limited in the region – could take months, Fortunately, Dr. Newbery had recently enrolled in a program that allowed her to consult with specialists throughout the province, using a web-based tool. With her patient's permission, Dr. Newbery took a 30-second video of the patient moving her arm. The video not only captured the abnormal shoulder movement, but the audio also picked up the crepitus. "Within five minutes, I was able to create an eConsult note to a pediatric orthope- dic surgeon and attach the video and ask my questions about appropriate imaging and management. The next day, I had a response that addressed all of my questions and allowed me to support the patient much more quickly than if she had had to wait for a face to face visit with an orthopedic surgeon, and without me order- ing unnecessary or unhelpful tests," said Dr. Newbery. Dr. Newbery said she also appreciated the fact that her patient and her family did not have to travel unnecessarily. "The coordina- tion of her care was quite seamless as it all happened in the context of her "medical home" in primary care." she said. That was not the only time that Dr. New- bery used eConsult to inform her clinical decision-making. She has used it regularly for dermatology cases, psychiatry cases and other musculoskeletal patient cases. "I live in a region of the province with limited special- ist access and eConsult allows me to access specialists that are not available in my region. I value the flexibility of being able to add im- ages and video as well." Since the launch of the Ontario eConsult Program in June 2018, the program has helped inform the clinical decision-making of thousands of health-care professionals like Dr. Newbery. More than 48,000 eConsults have been submitted since its launch. Supported by the Ministry of Health and Long-Term Care, the program connects physicians and nurse practitioners to special- ists via a secure, web-based tool. Through eConsult, physicians and nurse practitioners can receive prompt and secure advice from more than 90 specialties, including: addiction medicine, genetics, chronic pain, transgender care, cardiology, rheumatology, and neurol- ogy. Physicians and nurse practitioners receive ISSUE 3, 2019 DIALOGUE 47