@inbook{625eb038b4d84d52bd3e1de3cfbe4a6d,
title = "Widespread Adoption",
abstract = "BACKGROUND: Many health organizations are exploring the potential of electronic consultation (eConsult) services to address excessive wait times for specialist care. OBJECTIVE: To understand the effectiveness, population impact and costs associated with implementation of eConsult services. METHODS: We conducted a systematic review using a narrative synthesis approach. We searched Medline and Embase from inception to August 2014 (English/French). Included studies focused on communication between primary care providers and specialist physicians through an asynchronous, directed communication over a secure electronic medium. We assessed study quality with a modified version of the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies. We synthesized the results using the Triple Aim framework. RESULTS: A total of 36 studies were included. Most were set in the USA and focused on single-specialty services (most commonly dermatology). Population health outcomes included patient populations, adoption/utilization and provider attitudes. Providers cited timely advice from specialists, good medical care, confirmation of diagnoses and educational benefits. No clinical outcomes were reported. Patient experience of care was generally positive, with quick specialist response times (4.6 hours to 3.9 days), avoided referrals (12-84%) and satisfaction ranging from 78% to 93%. System costs were reported in only seven studies using different outcome measures and settings, limiting comparability. CONCLUSION: Though eConsult systems are highly acceptable for patients and providers and deliver improved access to specialist advice, gaps remain regarding eConsult's impact on population health and system costs. To achieve optimized health system performance, eConsult services must include specialty services as determined by community needs and further explore cost-effectiveness.",
keywords = "10, 1007, 15, 18 the branch of, Communication, Eye care utilization, Eye health education, Glaucoma suspect, Health Services Accessibility, Health disparities, Humans, Internet, Ocular hypertension, Patient Satisfaction, Primary Health Care, Primary open angle glaucoma, Randomized Controlled Trials as Topic, Remote Consultation, Specialization, Spectral domain optical coherence tomography, Telemedicine, Time Factors, Vision impairment, access to care, access to health care, areas, article, authorized users, but com-, contains supplementary material, correspondence, created in 1988 by, doi, e-health, economics, edu, efficiency, electronic supplementary material the, eye care utilization, eye health education, glaucoma suspect, has been based on, health disparities, health information systems, information management, m-health, medical informatics, methods, minas gerais and telehealth, mobile health, network of minas gerais, ocular hypertension, on physician time, online version of this, outpatient, owsley, patient satisfaction, primary care, primary health care, primary healthcare, primary open angle glaucoma, quality of healthcare, razilian public health system, reduce, referral, s11606-015-3489-x, some noble, special-, spectral domain optical coherence, statistics & numerical data, stitution, sus, system, telecommunica-, teleconsultation, telehealth, telehealth center, telemedicine, telemedicine technology used to, the electronic office visit, the federal con-, the unified health, tions, tomography, travel costs and demands, uab, universidade federal de, university hospital, vision impairment, which is available to",
author = "Clare Liddy and Paul Drosinis and Erin Keely and Hilty, {Donald M} and Nesbitt, {Thomas S} and Kuenneth, {Christina A} and Cruz, {Grace M} and Hales, {Robert E} and Ronald Schachter and Beatriz Tejera and Sagrario Bustabad and Wouter Janssen and Ryan Hickson and Jeffery Talbert and Thornbury, {William C} and Perin, {Nathan R} and Goodin, {Amie J} and Kenealy, {Timothy W} and Parsons, {Matthew J G} and Rouse, {A Paul B} and Doughty, {Robert N} and Sheridan, {Nicolette F} and Hindmarsh, {Jennifer K Harr{\'e}} and Masson, {Sarah C} and Rea, {Harry H} and Cynthia Owsley and Rhodes, {Lindsay A} and Jr, {Gerald Mcgwin} and Mennemeyer, {Stephen T} and Mary Bregantini and Nita Patel and Wiley, {Demond M} and Frank Larussa and Dan Box and Jinan Saaddine and Crews, {John E} and Girkin, {Christopher A} and Ribeiro Sales and Paula Rejane and Beserra Diniz and Waibel, {Kirk H} and Marcolino, {Milena Soriano} and Figueira, {Renato Minelli} and Cardoso, {Clareci Silva} and Ribeiro, {Antonio Luiz} and Alkmim, {Maria Beatriz} and Minas Gerais and Belo Horizonte and Universidade Federal and Gerais, {De Minas} and Belo Horizonte and Sa, {Universidade Federal De} and Emma Pitchforth and Winpenny, {Eleanor M} and Sarah King and Martin Roland and Polinski, {Jennifer M} and Tobias Barker and Nancy Gagliano and Andrew Sussman and Brennan, {Troyen A} and Shrank, {William H}",
year = "2016",
language = "American English",
isbn = "6469628117",
series = "Family practice",
pages = "1--10",
booktitle = "Family practice",
}
