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A pilot eConsultation service in Eastern Ontario: bridging clinical genetics and primary care

European Journal of Human Genetics (2019) | Download Citation

Abstract

With the rising demand for clinical genetics services, it is a challenge for clinical geneticists to meet the needs of patients and referring primary care providers in a timely way, using current models of genetics health care delivery. One method of providing primary care providers with greater access to clinical genetics expertise is through an electronic consultation (eConsult) service. We describe here a pilot project of a clinical genetics eConsult service that our genetics centre in Eastern Ontario, Canada provided, using the Champlain Building Access to Specialists through eConsultation (BASE)TM web-based application. We analyzed 111 genetics eConsults submitted by primary care providers to a single clinical geneticist over a 28-month time period. More than half (54%) of the eConsult questions were regarding (1) hereditary cancer and (2) genetic syndromes, with the remainder encompassing a wide variety of clinical genetics topics. We avoided a referral to the Genetics clinic for an in-person appointment for 30% of the eConsult cases, based on a contemplated referral rate to Genetics clinic of 72% prior to eConsult and a planned referral rate to Genetics clinic of 42% following all eConsults. Primary care providers rated the eConsult service of high value to themselves and also to their patients. This pilot service supports the potential of an eConsultation service to create a stronger and more dynamic link between clinical genetics and primary care providers, which may lead to better patient care.

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Acknowledgements

This work was supported by the Ministry of Health and Long-Term Care, The Canadian Institutes of Health Research, The Ottawa Hospital Academic Medical Organization Innovation Fund, e-Health Ontario, the University of Ottawa Department of Medicine, Bruyère Research Institute and the Champlain Local Health Integration Network.

Author information

Affiliations

  1. Department of Genetics, Children’s Hospital of Eastern Ontario, Ottawa, Ontario, Canada

    • Priya T. Bhola
    •  & Gail E. Graham
  2. CT Lamont Primary Healthcare Research Centre, Bruyere Research Institute, Ottawa, Ontario, Canada

    • Clare Liddy
  3. Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada

    • Clare Liddy
  4. The Champlain Local Health Integration Network, Ottawa, Ontario, Canada

    • Amir Afkham
  5. Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada

    • Erin Keely
  6. Division of Endocrinology/Metabolism, The Ottawa Hospital, Ottawa, Ontario, Canada

    • Erin Keely
  7. Ottawa Research Institute, Ottawa, Ontario, Canada

    • Erin Keely
  8. Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada

    • Gail E. Graham

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Conflict of interest

The authors declare that they have no conflict of interest.

Corresponding author

Correspondence to Priya T. Bhola.

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DOI

https://doi.org/10.1038/s41431-019-0342-4