HITS eHealth Office
eConsult Insider
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Dr. Ted Xenodemetropoulos, Gastroenterologist, Hamilton Health Sciences |
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Dr. Ted Xenodemetropoulos is an Associate Professor of Gastroenterology at McMaster University and a Consultant Gastroenterologist at Hamilton Heath Sciences. As a clinical champion and early adopter of eConsult, we sat down with him to chat about how he has incorporated eConsult into his practice.
Dr. Xenodemetropoulos’ clinical practice focuses on both acute and chronic luminal GI disease, liver disease and pancreatic disorders, but he also has a deep interest in the application and possibilities of information technology in healthcare.
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One of the earliest specialists available on eConsult, Dr. Xenodemetropoulos estimated that he has answered well over 600 eConsults over the past few years. Many of the eConsults he receives are from primary care providers in his network who appreciate his contextual and thorough review of patient history and detailed responses.
One primary care provider who frequently sends Dr. Xenodemetropoulos eConsults is Dr. Michael Pray of the Hamilton Family Health Team.
When we asked Dr. Pray for his experience of sending eConsults to Dr. Xenodemetropoulos, he said,
“eConsult is an essential tool for all the practitioners in our office. It allows for quick, efficient access to specialist advice, across the whole spectrum of clinical conditions.
It allows for collaboration and coordination of care. Patients are very happy that they can get this level of care without having to experience the waiting time and hassle of attending another consultation, but mostly that they can get a solution to their problem in their family doctor’s office.
While not holding the record for the speediest response (5 minutes from a certain HHS cardiologist), I don’t think I have waited more than 24 hours for a response from Dr. Xenodemetropoulos. A typical scenario was a patient from about 3 years ago, who looked slightly jaundice, with abnormal liver function tests. Dr. Xenodemetropoulos’ eConsult guided a timely referral to the gastroenterology clinic, where subsequent tests revealed a possible GI malignancy, leading to urgent surgery, which was successful with the patient being well and disease free at this time.”
– Dr. Michael Pray, Family Physician, Hamilton Family Health Team
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In speaking with Dr. Xenodemetropoulos, we asked the following questions:
If a primary care provider is trying to decide if they should send a referral or an eConsult, what should they consider?
Virtually anything, except for an emergent case, is fodder for an eConsult. For example, a primary care provider recently sent an eConsult like this,
“I have a patient who is X years old, has this family history, had a colonoscopy 10 years ago, do they need another one? How should I screen this patient?”
Other questions could be, “Does this patient need an urgent GI assessment? What are the next best steps? Is this a GI problem or a neurology problem?
Dr. Xenodemetropoulos said that a specific and targeted clinical question is best and leads to the best responses on eConsult. Specialists on eConsult won’t be able to provide a diagnosis or provide an elaborate investigation into the clinical circumstances of the patient but can provide advice on possible differential diagnoses, and next steps in further assessment and management, including indicating whether a referral is actually needed.
In your opinion, what are the main benefits
of eConsult for a primary care provider?
- Significantly reduces the need for formal referrals to the clinic
- Improves efficiency of care
- Builds relationships between primary care providers and specialists
- Provides continuing professional development for both primary care provider and specialist
- Both primary care providers and specialists are compensated
What are your perceived barriers to
primary care providers using eConsult?
Sometimes primary care providers aren’t aware which specialists are available on eConsult.
Did You Know? There are 281 specialists in HNHB who provide eConsults!
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Primary care providers may have a perception that signing up is complicated.
Did you Know? Primary care providers with a ONE ID can sign up for OTNHub and send their first eConsult in the same day.
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It can be time consuming to use eConsult as it's a tool outside of the EMR.
Did You Know? Primary care providers can nominate a delegate to manage eConsults; which can also be imported into the EMR.
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Primary care providers may have concerns about liability risk.
Did You Know? The Canadian Medical Protective Association (CMPA) supports the appropriate use of eHealth tools that enable physicians to more efficiently and effectively provide quality care to their patients while improving overall access to care.
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Data as of March 31, 2021. This data has been reproduced with permission from the Ontario eConsult Centre of Excellence. For more information, please contact eConsult@toh.ca. |
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Bundle eConsult and eReferral for Improved Access to Local Specialists |
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The HITS eHealth Office is now a participating partner in The Ontario eServices Program. The Ontario eServices Program delivers digital services that support clinical workflows and facilitate smoother transitions in care and an improved patient experience.
If after receiving specialist advice via eConsult the patient needs to be referred to a specialist, utilizing eReferral saves time booking appointments or contacting patients and reduces unnecessary referrals and no shows.
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eReferral is EMR Integrated
3 of the most common EMRs (TELUS PS Suite® EMR, Accuro® EMR and OSCAR EMRs) are integrated with the Ocean eReferral platform.
Many clinicians are also using the web portal and reporting significant benefits.
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Referral Destinations Continue to Grow Across HNHB
All the referral destinations that are currently accepting eReferrals through Ocean are publicly available on the Ocean Health Map.
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Opportunity for Specialists to use eReferral
Specialists receiving referrals via the Ocean eReferral platform can expect to spend less time on administrative tasks, including follow-up calls. You'll receive complete and legible referrals in TELUS PS Suite® EMR, Accuro® EMR and OSCAR EMRs) or via the easy to navigate web portal.
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New HNHB Pediatric Gastroenterology Group |
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The HITS eHealth Office is thrilled to announce the launch of a new HNHB Regional Group on eConsult!
HNHB Regional Pediatric Gastroenterology Group
This group of local specialists from McMaster Children's Hospital can answer eConsults that address infants, children and youth up to age 18 with problems related to nutrition, growth, chronic digestive complaints and problems of the intestine, liver, gall bladder and pancreas.
Group Specialists:
Dr. Bob Issenman
Dr. Herbert Brill
Dr. Nikhil Pai
Dr. Mary Zachos
How to Access an HNHB Regional Managed Group on eConsult:
Option 1: Use the OTNHub Directory and search for 'HNHB Regional [Specialty] Group'.
Option 2: With your 'Priority Region' already set to Hamilton Niagara Haldimand Brant (Read how to set your Priority Region here), select 'BASETM Managed Specialty Group' after initiating an eConsult, then select your desired specialty from the dropdown menu, including a sub-specialty if prompted. Proceed as normal with your eConsult.
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"My experience doing an eConsult through OTN has been great! One of my initial eConsults was on a pediatric patient that I needed to refer to a pediatric GI specialist. The wait would be long for this patient to be seen in-person. I did an eConsult to the pediatric gastroenterologist, who responded quickly with a plan for what he would recommend as his initial blood work and investigations. I completed these recommended tests with my patient, and was able to rule out several concerning diagnoses. The patient's in-person referral was then triaged to be seen more quickly with the additional information, and the specialist had more clinical information available at the appointment and was able to proceed directly to interventions. This saved time for both the patient and the specialist!"
– Julie Kingma, Nurse Practitioner, Primary Health Care
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COVID-19 Advice Available on eConsult |
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In response to the ongoing pandemic, the Ontario eConsult Centre of Excellence has created 4 COVID-related Managed Specialty Groups.
COVID-19 BASE™ Managed Specialty Group
- Accessed through the BASE™ managed specialty option and listed under Infectious Disease and Public Health
- A group of Infectious Disease specialists who can answer both patient-specific and general questions about COVID-19
COVID-19 and Autoimmune Disorders BASE™ Managed Specialty Group
- Accessed through the BASE™ Managed Specialty option and listed under COVID-19, Public Health and Rheumatology
- A group of Rheumatology specialists who can answer both patient-specific and general questions about COVID-19 and Autoimmune Disorders.
COVID-19 and Allergy/Immunology BASE™ Managed Specialty Group
- Accessed through the BASE™ Managed Specialty option and listed under COVID-19 and Allergy & Clinical Immunology.
- A group of Allergy & Clinical Immunology specialists who can answer both patient-specific and general questions about COVID-19 vaccine allergies
COVID-19 and Pregnancy BASE™ Managed Specialty Group
- Accessed through the BASE™ managed specialty option and listed under COVID-19, Public Health and Obstetrics.
- A group of Obstetrics specialists who can answer both patient-specific and general questions about COVID-19 and Pregnancy.
For non-patient specific questions please enter the patient information as follows:
First Name: COVID19
Last Name: COVID19
Date of Birth: 1900-01-01
Select 'OHIP number Not Available'
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For more information on anything in this email, or to schedule a follow-up appointment with our team, please contact us at the email listed below. |
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