Abstract

BackgroundThis study explores the effectiveness of an electronic consultation (eConsult) service between primary care providers and psychiatry, and the types and content of the clinical questions that were asked.MethodsThis is a retrospective eConsult review study. All eConsults directed to Psychiatry from July 2011 to January 2015 by Primary care providers were reviewed. Response time and the amount of time reported by the specialist to answer each eConsult was analyzed. Each eConsult was also categorized by clinical topic and question type in predetermined categories. Mandatory post-eConsult surveys for primary care providers were analyzed to determine the number of traditional consults avoided and to gain insight into the perceived value of eConsults.ResultsOf the 5597 eConsults, 169 psychiatry eConsults were completed during the study period. The average response time for a specialist to a primary care provider was 2.3 days. Eighty-seven percent of clinical responses were completed by the psychiatrist in less than 15 min. The primary care providers most commonly asked clinical questions were about depressive and anxiety disorders. 88.7% of PCPs rated the eConsult service a 5 (excellent value) or 4.ConclusionsThis study indicates that an eConsult psychiatry service has tremendous potential to improve access to psychiatric advice and expand the capacity to treat mental illness in primary care. Future research may include follow-up with PCPs regarding the implementation of specialist advice.

Highlights

  • This study explores the effectiveness of an electronic consultation service between primary care providers and psychiatry, and the types and content of the clinical questions that were asked

  • The Canadian Mental Health Association suggests the rates of Major Depressive Disorder (MDD) are higher amongst those living within rural and remote regions, yet these individuals face a number of barriers to receiving psychiatric care within their own communities

  • Of the 5597 eConsults directed to the service during the study period, 169 were to psychiatry (3.0%)

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Summary

Introduction

This study explores the effectiveness of an electronic consultation (eConsult) service between primary care providers and psychiatry, and the types and content of the clinical questions that were asked. The Canadian Mental Health Association suggests the rates of Major Depressive Disorder (MDD) are higher amongst those living within rural and remote regions, yet these individuals face a number of barriers to receiving psychiatric care within their own communities, In an effort to improve access to psychiatric care, curbside consultations are an important component of patient care. Carr et al [5] present details on a consultation liaison service as a way for family physicians to consult with an onsite trainee psychiatrist who provides expert knowledge to family physicians. Alternatives such as telepsychiatry and electronic consultations (eConsults) have been explored.

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