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Staykov E, Helmer-Smith M, Fung C, Tanuseputro P, Liddy C. Development of the electronic consultation long-term care utilization and savings estimator tool to model the potential impact of electronic consultation for residents living in long-term care. J Telemed Telecare 2024; 30:597-603. [PMID: 35073207 PMCID: PMC10988991 DOI: 10.1177/1357633x221074500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 12/28/2021] [Accepted: 12/29/2021] [Indexed: 02/21/2024]
Abstract
Ageing populations have resulted in more patients living in long-term care or nursing homes, where they face challenges to accessing prompt specialist care exacerbated in many cases by physical or cognitive decline. Electronic consultation has demonstrated an ability to improve access to specialist care for vulnerable groups and offers a potential solution to this gap in care. To support electronic consultation's uptake among long-term care homes, we created the electronic consultation long-term care utilization and savings estimator, an Excel-based tool that estimates the number of off-site appointments that patients in a long-term care home could avoid through electronic consultation, along with the consequent time and cost savings. In this brief report, we discuss the electronic consultation long-term care utilization and savings estimator's creation and function, and provide a case study using long-term care data to demonstrate its potential impact. We anticipate the electronic consultation long-term care utilization and savings estimator will be a highly impactful tool and intend to test it in real-world conditions following the relaxation of COVID-19 restrictions.
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Affiliation(s)
- Emiliyan Staykov
- Department of Biology, University of Ottawa, Canada
- Michael G. DeGroote School of Medicine, McMaster University, Canada
- Ottawa Hospital Research Institute, Canada
| | - Mary Helmer-Smith
- C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Canada
- Department of Family Medicine, University of Ottawa, Canada
| | - Celeste Fung
- Department of Family Medicine, University of Ottawa, Canada
- St Patrick’s Home of Ottawa, Canada
- Ontario eConsult Centre of Excellence, The Ottawa Hospital, Canada
| | - Peter Tanuseputro
- Ottawa Hospital Research Institute, Canada
- Division of Palliative Care, Department of Medicine, University of Ottawa, Canada
- Bruyère Research Institute, Bruyère Centre of Learning, Research and Innovation in Long-Term Care, Canada
| | - Clare Liddy
- C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Canada
- Department of Family Medicine, University of Ottawa, Canada
- Ontario eConsult Centre of Excellence, The Ottawa Hospital, Canada
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Hakimjavadi R, Karunananthan S, Levi C, LeBlanc K, Guglani S, Helmer-Smith M, Keely E, Liddy C. Electronic consultation use by advanced practice nurses in older adult care-A descriptive study of service utilization data. Nurs Open 2023; 10:2240-2248. [PMID: 36373892 PMCID: PMC10006590 DOI: 10.1002/nop2.1476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 10/22/2022] [Indexed: 11/16/2022] Open
Abstract
AIMS AND OBJECTIVES To describe characteristics of service utilization by advanced practice nurses (APNs) employing an electronic consultation (eConsult) service in their care for older adults. BACKGROUND Canada's aging population is projected to place unprecedented demands on the healthcare system. APNs, which include clinical nurse specialists (CNSs) and nurse practitioners (NPs), are nurses with advanced knowledge who can independently provide age-appropriate care. eConsult is a secure web-based platform enabling asynchronous, provider-to-provider communication. APNs can send and receive eConsults to address patient-specific concerns. METHODS This is a retrospective analysis of eConsult utilization and user survey data for cases completed in 2019, reported in line with the STROBE guidelines. Eligible eConsults included those that had APN involvement (as a referrer or responder) and were concerning an older patient (≥65 years). Descriptive statistics were used to analyse service utilization and survey response data. RESULTS Of 430 eligible eConsults, 421 (97.9%) were initiated by NPs and the rest by physicians. 23 (5.3%) were received by a CNS, of which 14 (3.3%) involved an NP-to-CNS exchange. Median specialist response interval was 0.9 days. 53% of eConsults was for dermatology, haematology, cardiology, gastroenterology and endocrinology. 73% of eConsults avoided a face-to-face referral after the consultation. In 90% of eConsults, APNs rated the service as helpful and/or educational. CONCLUSIONS Through eConsult, APNs can collaborate with each other and physicians to access and provide a breadth of advice facilitating timely specialist-informed care for older patients, thus helping to alleviate some of the demands placed on the healthcare system. RELEVANCE TO CLINICAL PRACTICE There is an opportunity for APNs to further adopt eConsult into their clinical practice, and this can, in turn, support the integration of the APN role in the health workforce. PATIENT OR PUBLIC CONTRIBUTION Current APN eConsult users were involved in the study design and interpretation of results.
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Affiliation(s)
- Ramtin Hakimjavadi
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.,C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, Ontario, Canada
| | - Sathya Karunananthan
- C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, Ontario, Canada.,Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Cheryl Levi
- Emergency Department Outreach Program, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Kimberly LeBlanc
- Nurses Specialized in Wound, Ostomy, and Continence, Ottawa, Ontario, Canada.,Advanced Practice Nurse (Wound, Ostomy, and Continence), KDS Professional Consulting, Ottawa, Ontario, Canada
| | - Sheena Guglani
- C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, Ontario, Canada
| | - Mary Helmer-Smith
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.,Centre for Health Services and Policy Research, University of British Columbia, Vancouver, British Columbia, Canada
| | - Erin Keely
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.,Division of Endocrinology/Metabolism, The Ottawa Hospital, Ottawa, Ontario, Canada.,eConsult Centre of Excellence, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Clare Liddy
- C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, Ontario, Canada.,eConsult Centre of Excellence, The Ottawa Hospital, Ottawa, Ontario, Canada.,Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada
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Hakimjavadi R, Karunananthan S, Fung C, Levi C, Helmer-Smith M, LaPlante J, Gazarin M, Rahgozar A, Afkham A, Keely E, Liddy C. Using electronic consultation (eConsult) to identify frailty in provider-to-provider communication: a feasibility and validation study. BMC Geriatr 2023; 23:136. [PMID: 36894892 PMCID: PMC9999527 DOI: 10.1186/s12877-023-03870-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 03/03/2023] [Indexed: 03/11/2023] Open
Abstract
BACKGROUND Frailty is a complex age-related clinical condition that increases vulnerability to stressors. Early recognition of frailty is challenging. While primary care providers (PCPs) serve as the first point of contact for most older adults, convenient tools for identifying frailty in primary care are lacking. Electronic consultation (eConsult), a platform connecting PCPs to specialists, is a rich source of provider-to-provider communication data. Text-based patient descriptions on eConsult may provide opportunities for earlier identification of frailty. We sought to explore the feasibility and validity of identifying frailty status using eConsult data. METHODS eConsult cases closed in 2019 and submitted on behalf of long-term care (LTC) residents or community-dwelling older adults were sampled. A list of frailty-related terms was compiled through a review of the literature and consultation with experts. To identify frailty, eConsult text was parsed to measure the frequency of frailty-related terms. Feasibility of this approach was assessed by examining the availability of frailty-related terms in eConsult communication logs, and by asking clinicians to indicate whether they can assess likelihood of frailty by reviewing the cases. Construct validity was assessed by comparing the number of frailty-related terms in cases about LTC residents with those about community-dwelling older adults. Criterion validity was assessed by comparing clinicians' ratings of frailty to the frequency of frailty-related terms. RESULTS One hundred thirteen LTC and 112 community cases were included. Frailty-related terms identified per case averaged 4.55 ± 3.95 in LTC and 1.96 ± 2.68 in the community (p < .001). Clinicians consistently rated cases with ≥ 5 frailty-related terms as highly likely of living with frailty. CONCLUSIONS The availability of frailty-related terms establishes the feasibility of using provider-to-provider communication on eConsult to identify patients with high likelihood of living with this condition. The higher average of frailty-related terms in LTC (versus community) cases, and agreement between clinician-provided frailty ratings and the frequency of frailty-related terms, support the validity of an eConsult-based approach to identifying frailty. There is potential for eConsult to be used as a case-finding tool in primary care for early recognition and proactive initiation of care processes for older patients living with frailty.
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Affiliation(s)
- Ramtin Hakimjavadi
- Faculty of Medicine, University of Ottawa, Ottawa, Canada.,C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, Canada
| | - Sathya Karunananthan
- C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, Canada.,Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Celeste Fung
- Department of Family Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada.,St. Patrick's Home of Ottawa, Ottawa, Canada
| | - Cheryl Levi
- Emergency Department Outreach Program, The Ottawa Hospital, Ottawa, Canada
| | - Mary Helmer-Smith
- School of Population and Public Health, Centre for Health Services and Policy Research, University of British Columbia, Vancouver, British Columbia, Canada
| | - James LaPlante
- C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, Canada
| | - Mohamed Gazarin
- Centre of Excellence for Rural Health and Education, Winchester District Memorial Hospital, Winchester, Ontario, Canada
| | - Arya Rahgozar
- Department of Family Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Amir Afkham
- Ontario Health East, Ottawa, Canada.,Ontario eConsult Centre of Excellence, The Ottawa Hospital, Ottawa, Canada
| | - Erin Keely
- Ontario eConsult Centre of Excellence, The Ottawa Hospital, Ottawa, Canada.,Department of Medicine, University of Ottawa, Ottawa, Canada
| | - Clare Liddy
- C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, Canada. .,Department of Family Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada. .,Ontario eConsult Centre of Excellence, The Ottawa Hospital, Ottawa, Canada.
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McCutcheon T, LaPlante J, Bibeau C, Cooper L, Hammond J, Helmer-Smith M, Houghton D, Burns KK, Mastin D, Turner K, Liddy C. Building patient-oriented research capacity by co-designing a research handbook for patient partners. Patient Educ Couns 2022; 105:3331-3333. [PMID: 35817634 PMCID: PMC9258416 DOI: 10.1016/j.pec.2022.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 05/06/2022] [Accepted: 07/01/2022] [Indexed: 06/15/2023]
Affiliation(s)
- Tess McCutcheon
- C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, Ontario, Canada
| | - James LaPlante
- C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, Ontario, Canada
| | | | - Lynn Cooper
- C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, Ontario, Canada
| | - Jessika Hammond
- C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, Ontario, Canada
| | - Mary Helmer-Smith
- C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, Ontario, Canada
| | - Deanne Houghton
- C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, Ontario, Canada
| | - Katharina Kovacs Burns
- School of Public Health, Edmonton Clinic Health Academy, University of Alberta, Edmonton, Canada
| | - Donald Mastin
- C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, Ontario, Canada
| | | | - Clare Liddy
- C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, Ontario, Canada; Department of Family Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada; Ontario eConsult Centre of Excellence, The Ottawa Hospital, Ottawa, Canada.
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Sethuram C, Helmer-Smith M, Karunananthan S, Keely E, Singh J, Liddy C. Electronic consultation in correctional facilities worldwide: a scoping review. BMJ Open 2022; 12:e055049. [PMID: 35922103 PMCID: PMC9352998 DOI: 10.1136/bmjopen-2021-055049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To provide an overview of the use of and evidence for eConsult in correctional facilities worldwide. DESIGN Scoping review. DATA SOURCES Three academic databases (MEDLINE, Embase and CINAHL) were searched to identify papers published between 1990 and 2020 that presented data on eConsult use in correctional facilities. The grey literature was also searched for any resources that discussed eConsult use in correctional facilities. Articles and resources were excluded if they discussed synchronous, patient-to-provider or unsecure communication. The reference lists of included articles were also hand searched. RESULTS Of the 226 records retrieved from the academic literature search and 595 from the grey literature search, 22 were included in the review. Most study populations included adult male offenders in a variety of correctional environments. These resources identified 13 unique eConsult services in six countries. Six of these services involved multiple medical specialties, while the remaining services were single specialty. The available evidence was organised into five identified themes: feasibility, cost-effectiveness, access to care, provider satisfaction and clinical impact. CONCLUSIONS This study identified evidence that the use of eConsult in correctional facilities is beneficial and avoids unnecessary transportation of offenders outside of the facilities. It is feasible, cost-effective, increases access to care, has an impact on clinical care and has high provider satisfaction. Some gaps in the literature remain, and we suggest further research on patient satisfaction, enablers and barriers to implementation, and women, youth and transgender populations in this setting to inform service providers and stakeholders. Despite some gaps, eConsult is evidently an important tool to provide timely, high-quality care to offenders.
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Affiliation(s)
- Claire Sethuram
- C.T. Lamont Primary Health Care Research Centre, Bruyere Research Institute, Ottawa, Ontario, Canada
- Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Mary Helmer-Smith
- C.T. Lamont Primary Health Care Research Centre, Bruyere Research Institute, Ottawa, Ontario, Canada
- Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Sathya Karunananthan
- C.T. Lamont Primary Health Care Research Centre, Bruyere Research Institute, Ottawa, Ontario, Canada
- Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Erin Keely
- Ontario eConsult Centre of Excellence, The Ottawa Hospital, Ottawa, Ontario, Canada
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Division of Endocrinology/Metabolism, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Jatinderpreet Singh
- Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Clare Liddy
- C.T. Lamont Primary Health Care Research Centre, Bruyere Research Institute, Ottawa, Ontario, Canada
- Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Ontario eConsult Centre of Excellence, The Ottawa Hospital, Ottawa, Ontario, Canada
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Yan H, Rahgozar A, Sethuram C, Karunananthan S, Archibald D, Bradley L, Hakimjavadi R, Helmer-Smith M, Jolin-Dahel K, McCutcheon T, Puncher J, Rezaiefar P, Shoppoff L, Liddy C. Correction: Natural Language Processing to Identify Digital Learning Tools in Postgraduate Family Medicine: Protocol for a Scoping Review. JMIR Res Protoc 2022; 11:e40454. [PMID: 35749727 PMCID: PMC9270704 DOI: 10.2196/40454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 06/21/2022] [Indexed: 11/29/2022] Open
Affiliation(s)
- Hui Yan
- Department of Family Medicine, University of Ottawa, Ottawa, ON, Canada.,Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Arya Rahgozar
- Department of Family Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Claire Sethuram
- Bruyère Research Institute, Ottawa, ON, Canada.,Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Sathya Karunananthan
- Bruyère Research Institute, Ottawa, ON, Canada.,Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Douglas Archibald
- Department of Family Medicine, University of Ottawa, Ottawa, ON, Canada.,Bruyère Research Institute, Ottawa, ON, Canada
| | - Lindsay Bradley
- Department of Family Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Ramtin Hakimjavadi
- Department of Family Medicine, University of Ottawa, Ottawa, ON, Canada.,Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Mary Helmer-Smith
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | | | | | - Jeffrey Puncher
- Department of Family Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Parisa Rezaiefar
- Department of Family Medicine, University of Ottawa, Ottawa, ON, Canada.,Bruyère Research Institute, Ottawa, ON, Canada
| | - Lina Shoppoff
- Department of Family Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Clare Liddy
- Department of Family Medicine, University of Ottawa, Ottawa, ON, Canada.,Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.,Bruyère Research Institute, Ottawa, ON, Canada
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Yan H, Rahgozar A, Sethuram C, Karunananthan S, Archibald D, Bradley L, Hakimjavadi R, Helmer-Smith M, Jolin-Dahel K, McCutcheon T, Puncher J, Rezaiefar P, Shoppoff L, Liddy C. Natural Language Processing to Identify Digital Learning Tools in Postgraduate Family Medicine: Protocol for a Scoping Review. JMIR Res Protoc 2022; 11:e34575. [PMID: 35499861 PMCID: PMC9112078 DOI: 10.2196/34575] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 01/24/2022] [Accepted: 03/21/2022] [Indexed: 02/06/2023] Open
Abstract
Background The COVID-19 pandemic has highlighted the growing need for digital learning tools in postgraduate family medicine training. Family medicine departments must understand and recognize the use and effectiveness of digital tools in order to integrate them into curricula and develop effective learning tools that fill gaps and meet the learning needs of trainees. Objective This scoping review will aim to explore and organize the breadth of knowledge regarding digital learning tools in family medicine training. Methods This scoping review follows the 6 stages of the methodological framework outlined first by Arksey and O’Malley, then refined by Levac et al, including a search of published academic literature in 6 databases (MEDLINE, ERIC, Education Source, Embase, Scopus, and Web of Science) and gray literature. Following title and abstract and full text screening, characteristics and main findings of the included studies and resources will be tabulated and summarized. Thematic analysis and natural language processing (NLP) will be conducted in parallel using a 9-step approach to identify common themes and synthesize the literature. Additionally, NLP will be employed for bibliometric and scientometric analysis of the identified literature. Results The search strategy has been developed and launched. As of October 2021, we have completed stages 1, 2, and 3 of the scoping review. We identified 132 studies for inclusion through the academic literature search and 127 relevant studies in the gray literature search. Further refinement of the eligibility criteria and data extraction has been ongoing since September 2021. Conclusions In this scoping review, we will identify and consolidate information and evidence related to the use and effectiveness of existing digital learning tools in postgraduate family medicine training. Our findings will improve the understanding of the current landscape of digital learning tools, which will be of great value to educators and trainees interested in using existing tools, innovators looking to design digital learning tools that meet current needs, and researchers involved in the study of digital tools. Trial Registration OSF Registries osf.io/wju4k; https://osf.io/wju4k International Registered Report Identifier (IRRID) DERR1-10.2196/34575
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Affiliation(s)
- Hui Yan
- Department of Family Medicine, University of Ottawa, Ottawa, ON, Canada
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Arya Rahgozar
- Department of Family Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Claire Sethuram
- Bruyère Research Institute, Ottawa, ON, Canada
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Sathya Karunananthan
- Bruyère Research Institute, Ottawa, ON, Canada
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Douglas Archibald
- Department of Family Medicine, University of Ottawa, Ottawa, ON, Canada
- Bruyère Research Institute, Ottawa, ON, Canada
| | - Lindsay Bradley
- Department of Family Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Ramtin Hakimjavadi
- Department of Family Medicine, University of Ottawa, Ottawa, ON, Canada
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Mary Helmer-Smith
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | | | | | - Jeffrey Puncher
- Department of Family Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Parisa Rezaiefar
- Department of Family Medicine, University of Ottawa, Ottawa, ON, Canada
- Bruyère Research Institute, Ottawa, ON, Canada
| | - Lina Shoppoff
- Department of Family Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Clare Liddy
- Department of Family Medicine, University of Ottawa, Ottawa, ON, Canada
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- Bruyère Research Institute, Ottawa, ON, Canada
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8
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Hakimjavadi R, Levi C, LeBlanc K, Guglani S, Helmer-Smith M, Joschko J, Karunananthan S, Keely E, Liddy C. Electronic Consultation by Advanced Practice Nurses to Improve Access to Specialist Care for Older Adults. J Gerontol Nurs 2022; 48:33-40. [PMID: 35343843 DOI: 10.3928/00989134-20220307-02] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Older adults face several challenges when accessing specialist care. Advanced practice nurses (APNs) can perform an important role in primary care for older adults, particularly when bolstered with digital tools. In the current study, we conducted a multiple case study of electronic consultations (eConsults) involving APNs to assess how these practitioners use the service to improve access to care. All eConsults submitted by or to an APN in 2019 on behalf of patients aged ≥65 years were reviewed to identify examples from six settings representative of the range of advanced nursing practices. For each setting, a final case was chosen using an iterative process and stratified by specialty and type of advice. Included cases were assessed using a conceptual framework for health care access. Selected cases illustrate how APNs can be effective users of eConsults in a diversity of health care settings. The framework allowed for an in-depth study of access over the range of interactions that take place among patients, caregivers, providers, and the health care system. [Journal of Gerontological Nursing, 48(4), 33-40.].
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Fung C, Shah S, Helmer-Smith M, Levi C, Keely E, Liddy C. Clinical Questions Asked by Long-Term Care Providers Through eConsult: A Retrospective Study. Gerontol Geriatr Med 2021; 7:23337214211032055. [PMID: 34471649 PMCID: PMC8404619 DOI: 10.1177/23337214211032055] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 06/16/2021] [Accepted: 06/24/2021] [Indexed: 02/02/2023] Open
Abstract
Introduction eConsult allows primary care providers (PCPs) to access timely specialist advice and informs patient care. To understand the use of eConsult in long-term care (LTC) settings, we examined the clinical content and types of questions asked by LTC PCPs. Methods A descriptive, retrospective study of eConsults submitted through the Champlain BASE™ eConsult Service between January 1, 2017, and December 31, 2018, by LTC PCPs was conducted. Cases were classified using validated taxonomies. Descriptive statistics were generated for content and question type classifications, service utilization data, and close-out survey responses. Results 22 LTC PCPs submitted 113 eConsults. They sought advice about drug treatment (58%), diagnosis (44%), and management (38%) in a breadth of clinical areas, often skin-related (39%). Long-term care PCPs frequently asked more than one question type (42%). They received advice within 1 week (91%) and rated eConsult as very helpful and educational. Three case examples are presented. Conclusion This study demonstrates the type of advice LTC PCPs are seeking through eConsult and its usefulness in this setting. Long-term care stakeholders are encouraged to consider implementing eConsult in other regions, as a means to improve access to timely specialist advice, support clinical decision-making, and improve residents’ quality of life.
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Affiliation(s)
- Celeste Fung
- St. Patrick's Home of Ottawa, Ottawa, ON, Canada.,Department of Family Medicine, University of Ottawa, Ottawa, ON, Canada.,Ontario eConsult Centre of Excellence, The Ottawa Hospital, Ottawa, ON, Canada
| | - Soha Shah
- Department of Family Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Mary Helmer-Smith
- Department of Family Medicine, University of Ottawa, Ottawa, ON, Canada.,C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, ON, Canada
| | - Cheryl Levi
- Emergency Department Outreach Program, The Ottawa Hospital, Ottawa, ON, Canada
| | - Erin Keely
- Ontario eConsult Centre of Excellence, The Ottawa Hospital, Ottawa, ON, Canada.,Department of Medicine, University of Ottawa, Ottawa, ON, Canada.,Division of Endocrinology/Metabolism, The Ottawa Hospital, Ottawa, ON, Canada
| | - Clare Liddy
- Department of Family Medicine, University of Ottawa, Ottawa, ON, Canada.,Ontario eConsult Centre of Excellence, The Ottawa Hospital, Ottawa, ON, Canada.,C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, ON, Canada
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10
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Helmer-Smith M, Fung C, Afkham A, Crowe L, Gazarin M, Keely E, Moroz I, Liddy C. The Feasibility of Using Electronic Consultation in Long-Term Care Homes. J Am Med Dir Assoc 2020; 21:1166-1170.e2. [DOI: 10.1016/j.jamda.2020.03.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 03/03/2020] [Accepted: 03/06/2020] [Indexed: 10/24/2022]
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Cazabon D, Castro A, Cinà M, Helmer-Smith M, Vlček C, Oghor C. A case study of Gavi'S human papillomavirus vaccine support programme. ACTA ACUST UNITED AC 2017. [DOI: 10.4103/2468-6360.198797] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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