Use of eConsult to enhance genetics service delivery in primary care: A multimethod study.

Autor:	Carroll JC; Ray D. Wolfe Department of Family Medicine, Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada; Department of Family & Community Medicine, University of Toronto, Ontario, Canada. Electronic address: June.Carroll@sinaihealth.ca., Liddy C; C.T. Lamont Primary Health Care Research Centre, Bruyere Research Institute, Ottawa, Ontario, Canada; Department of Family Medicine, University of Ottawa, Ontario, Canada; Ontario eConsult Centre of Excellence, The Ottawa Hospital, Ottawa, Ontario, Canada., Afkham A; Ontario Health East, Ottawa, Ontario, Canada., Keely E; Ontario eConsult Centre of Excellence, The Ottawa Hospital, Ottawa, Ontario, Canada; Division of Endocrinology & Metabolism, The Ottawa Hospital, Ottawa, Ontario, Canada; Department of Medicine, University of Ottawa, Ontario, Canada., Goh ES; Laboratory Medicine and Genetics and Institute for Better Health, Trillium Health Partners, Mississauga, Ontario, Canada; Department of Laboratory Medicine & Pathobiology, University of Toronto, Ontario, Canada., Graham GE; Department of Pediatrics, University of Ottawa, Ontario, Canada; Department of Genetics, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada., Permaul JA; Ray D. Wolfe Department of Family Medicine, Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada., Allanson J; Department of Pediatrics, University of Ottawa, Ontario, Canada; Department of Genetics, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada., Heisey R; Department of Family & Community Medicine, University of Toronto, Ontario, Canada; Department of Family and Community Medicine, Women's College Hospital, Toronto, Ontario, Canada., Makuwaza T; Ray D. Wolfe Department of Family Medicine, Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada., Manca DP; Department of Family Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada., O'Brien MA; Department of Family & Community Medicine, University of Toronto, Ontario, Canada., Grunfeld E; Department of Family & Community Medicine, University of Toronto, Ontario, Canada; Ontario Institute for Cancer Research, Toronto, Ontario, Canada.
Jazyk:	angličtina
Zdroj:	Genetics in medicine : official journal of the American College of Medical Genetics [Genet Med] 2022 Oct; Vol. 24 (10), pp. 2034-2041. Date of Electronic Publication: 2022 Aug 10.
DOI:	10.1016/j.gim.2022.07.003
Abstrakt:	Purpose: Electronic consultation (eConsult) is a freely-available secure online platform connecting primary care providers (PCPs) to geneticists. Our purpose was to determine whether eConsult is effective in improving genetics service delivery in primary care. Methods: PCP questionnaires regarding eConsult's utility, geneticists' tracking form assessments of eConsult type and appropriateness, and geneticists' interviews on implementing eConsult were carried out. Results: In 2 regions of Ontario, Canada, from January 2019 to June 2020, there were 305 genetics eConsults. For 169 (55%), PCPs indicated receiving good advice for a new course of action; for 110 (36%), referral was now avoided; and for 261 (86%), eConsult was perceived valuable for patient management. Of the 131 geneticist-completed tracking forms, cancer questions were most common (68, 52%). For 63 (48%), geneticists disagreed/strongly disagreed PCPs should know the answer to the referral question. From the interview data, it was observed that geneticists described eConsult positively and suggested how it might improve access and efficiencies if integrated into genetic service delivery. Dealing with eConsults virtually could reduce waitlists, and suggesting appropriate investigations for PCPs could improve efficiencies. Conclusion: eConsult offers a potential solution for receiving timely genetics advice and avoiding unnecessary patient referrals, however, greater effect on access and wait times will need systematic integration into PCP and geneticist practice. Competing Interests: Conflict of Interest C.L. and E.K. are cofounders of the Champlain BASE eConsult Service, but they have no commercial interest in the service and do not retain any proprietary rights. As Coexecutive Directors of the Ontario eConsult Centre of Excellence, they receive salary support from the Ontario Ministry of Health. E.K. answers occasional electronic consultations (less than 1 per month) as a specialist through the service for which she is reimbursed. All other authors report no conflicts of interest. (Copyright © 2022 American College of Medical Genetics and Genomics. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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