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Impact of the Connected Medicine collaborative in improving access to specialist care: a cross-sectional analysis

Clare Liddy, Emma Boulay, Lois Crowe, Maxine Dumas-Pilon, Neil Drimer, Gerard Farrell, Laurie Ireland, Christine (Kirby) Kirvan, Veronique Nabelsi, Alexander Singer, Margot Wilson and Erin Keely
December 14, 2021 9 (4) E1187-E1194; DOI: https://doi.org/10.9778/cmajo.20200210
Clare Liddy
C.T. Lamont Primary Health Care Research Centre, Department of Family Medicine (Liddy, Crowe), Department of Medicine (Keely), University of Ottawa; eConsult Centre of Excellence (Liddy, Keely), The Ottawa Hospital; Bruyère Research Institute (Crowe); Canadian Foundation for Healthcare Improvement (Drimer, Kirvan), Ottawa, Ont.; New Brunswick Medical Society (Boulay), Fredericton, NB; Department of Family Medicine (Dumas-Pilon), McGill University, Montréal, Que.; Department of Family Medicine (Farrell), Memorial University of Newfoundland, St. John’s, NL; Nine Circles Community Health Centre (Ireland) and Department of Family Medicine (Singer), University of Manitoba, Winnipeg, Man.; Université du Québec en Outaouais (Nabelsi), Gatineau, Que.; Providence Health Care (Wilson), Vancouver, BC
MD MSc
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Emma Boulay
C.T. Lamont Primary Health Care Research Centre, Department of Family Medicine (Liddy, Crowe), Department of Medicine (Keely), University of Ottawa; eConsult Centre of Excellence (Liddy, Keely), The Ottawa Hospital; Bruyère Research Institute (Crowe); Canadian Foundation for Healthcare Improvement (Drimer, Kirvan), Ottawa, Ont.; New Brunswick Medical Society (Boulay), Fredericton, NB; Department of Family Medicine (Dumas-Pilon), McGill University, Montréal, Que.; Department of Family Medicine (Farrell), Memorial University of Newfoundland, St. John’s, NL; Nine Circles Community Health Centre (Ireland) and Department of Family Medicine (Singer), University of Manitoba, Winnipeg, Man.; Université du Québec en Outaouais (Nabelsi), Gatineau, Que.; Providence Health Care (Wilson), Vancouver, BC
MA
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Lois Crowe
C.T. Lamont Primary Health Care Research Centre, Department of Family Medicine (Liddy, Crowe), Department of Medicine (Keely), University of Ottawa; eConsult Centre of Excellence (Liddy, Keely), The Ottawa Hospital; Bruyère Research Institute (Crowe); Canadian Foundation for Healthcare Improvement (Drimer, Kirvan), Ottawa, Ont.; New Brunswick Medical Society (Boulay), Fredericton, NB; Department of Family Medicine (Dumas-Pilon), McGill University, Montréal, Que.; Department of Family Medicine (Farrell), Memorial University of Newfoundland, St. John’s, NL; Nine Circles Community Health Centre (Ireland) and Department of Family Medicine (Singer), University of Manitoba, Winnipeg, Man.; Université du Québec en Outaouais (Nabelsi), Gatineau, Que.; Providence Health Care (Wilson), Vancouver, BC
BA
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Maxine Dumas-Pilon
C.T. Lamont Primary Health Care Research Centre, Department of Family Medicine (Liddy, Crowe), Department of Medicine (Keely), University of Ottawa; eConsult Centre of Excellence (Liddy, Keely), The Ottawa Hospital; Bruyère Research Institute (Crowe); Canadian Foundation for Healthcare Improvement (Drimer, Kirvan), Ottawa, Ont.; New Brunswick Medical Society (Boulay), Fredericton, NB; Department of Family Medicine (Dumas-Pilon), McGill University, Montréal, Que.; Department of Family Medicine (Farrell), Memorial University of Newfoundland, St. John’s, NL; Nine Circles Community Health Centre (Ireland) and Department of Family Medicine (Singer), University of Manitoba, Winnipeg, Man.; Université du Québec en Outaouais (Nabelsi), Gatineau, Que.; Providence Health Care (Wilson), Vancouver, BC
MD
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Neil Drimer
C.T. Lamont Primary Health Care Research Centre, Department of Family Medicine (Liddy, Crowe), Department of Medicine (Keely), University of Ottawa; eConsult Centre of Excellence (Liddy, Keely), The Ottawa Hospital; Bruyère Research Institute (Crowe); Canadian Foundation for Healthcare Improvement (Drimer, Kirvan), Ottawa, Ont.; New Brunswick Medical Society (Boulay), Fredericton, NB; Department of Family Medicine (Dumas-Pilon), McGill University, Montréal, Que.; Department of Family Medicine (Farrell), Memorial University of Newfoundland, St. John’s, NL; Nine Circles Community Health Centre (Ireland) and Department of Family Medicine (Singer), University of Manitoba, Winnipeg, Man.; Université du Québec en Outaouais (Nabelsi), Gatineau, Que.; Providence Health Care (Wilson), Vancouver, BC
MHSc
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Gerard Farrell
C.T. Lamont Primary Health Care Research Centre, Department of Family Medicine (Liddy, Crowe), Department of Medicine (Keely), University of Ottawa; eConsult Centre of Excellence (Liddy, Keely), The Ottawa Hospital; Bruyère Research Institute (Crowe); Canadian Foundation for Healthcare Improvement (Drimer, Kirvan), Ottawa, Ont.; New Brunswick Medical Society (Boulay), Fredericton, NB; Department of Family Medicine (Dumas-Pilon), McGill University, Montréal, Que.; Department of Family Medicine (Farrell), Memorial University of Newfoundland, St. John’s, NL; Nine Circles Community Health Centre (Ireland) and Department of Family Medicine (Singer), University of Manitoba, Winnipeg, Man.; Université du Québec en Outaouais (Nabelsi), Gatineau, Que.; Providence Health Care (Wilson), Vancouver, BC
MD
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Laurie Ireland
C.T. Lamont Primary Health Care Research Centre, Department of Family Medicine (Liddy, Crowe), Department of Medicine (Keely), University of Ottawa; eConsult Centre of Excellence (Liddy, Keely), The Ottawa Hospital; Bruyère Research Institute (Crowe); Canadian Foundation for Healthcare Improvement (Drimer, Kirvan), Ottawa, Ont.; New Brunswick Medical Society (Boulay), Fredericton, NB; Department of Family Medicine (Dumas-Pilon), McGill University, Montréal, Que.; Department of Family Medicine (Farrell), Memorial University of Newfoundland, St. John’s, NL; Nine Circles Community Health Centre (Ireland) and Department of Family Medicine (Singer), University of Manitoba, Winnipeg, Man.; Université du Québec en Outaouais (Nabelsi), Gatineau, Que.; Providence Health Care (Wilson), Vancouver, BC
MD
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Christine (Kirby) Kirvan
C.T. Lamont Primary Health Care Research Centre, Department of Family Medicine (Liddy, Crowe), Department of Medicine (Keely), University of Ottawa; eConsult Centre of Excellence (Liddy, Keely), The Ottawa Hospital; Bruyère Research Institute (Crowe); Canadian Foundation for Healthcare Improvement (Drimer, Kirvan), Ottawa, Ont.; New Brunswick Medical Society (Boulay), Fredericton, NB; Department of Family Medicine (Dumas-Pilon), McGill University, Montréal, Que.; Department of Family Medicine (Farrell), Memorial University of Newfoundland, St. John’s, NL; Nine Circles Community Health Centre (Ireland) and Department of Family Medicine (Singer), University of Manitoba, Winnipeg, Man.; Université du Québec en Outaouais (Nabelsi), Gatineau, Que.; Providence Health Care (Wilson), Vancouver, BC
MA
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Veronique Nabelsi
C.T. Lamont Primary Health Care Research Centre, Department of Family Medicine (Liddy, Crowe), Department of Medicine (Keely), University of Ottawa; eConsult Centre of Excellence (Liddy, Keely), The Ottawa Hospital; Bruyère Research Institute (Crowe); Canadian Foundation for Healthcare Improvement (Drimer, Kirvan), Ottawa, Ont.; New Brunswick Medical Society (Boulay), Fredericton, NB; Department of Family Medicine (Dumas-Pilon), McGill University, Montréal, Que.; Department of Family Medicine (Farrell), Memorial University of Newfoundland, St. John’s, NL; Nine Circles Community Health Centre (Ireland) and Department of Family Medicine (Singer), University of Manitoba, Winnipeg, Man.; Université du Québec en Outaouais (Nabelsi), Gatineau, Que.; Providence Health Care (Wilson), Vancouver, BC
PhD
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Alexander Singer
C.T. Lamont Primary Health Care Research Centre, Department of Family Medicine (Liddy, Crowe), Department of Medicine (Keely), University of Ottawa; eConsult Centre of Excellence (Liddy, Keely), The Ottawa Hospital; Bruyère Research Institute (Crowe); Canadian Foundation for Healthcare Improvement (Drimer, Kirvan), Ottawa, Ont.; New Brunswick Medical Society (Boulay), Fredericton, NB; Department of Family Medicine (Dumas-Pilon), McGill University, Montréal, Que.; Department of Family Medicine (Farrell), Memorial University of Newfoundland, St. John’s, NL; Nine Circles Community Health Centre (Ireland) and Department of Family Medicine (Singer), University of Manitoba, Winnipeg, Man.; Université du Québec en Outaouais (Nabelsi), Gatineau, Que.; Providence Health Care (Wilson), Vancouver, BC
MB BAO BCh
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Margot Wilson
C.T. Lamont Primary Health Care Research Centre, Department of Family Medicine (Liddy, Crowe), Department of Medicine (Keely), University of Ottawa; eConsult Centre of Excellence (Liddy, Keely), The Ottawa Hospital; Bruyère Research Institute (Crowe); Canadian Foundation for Healthcare Improvement (Drimer, Kirvan), Ottawa, Ont.; New Brunswick Medical Society (Boulay), Fredericton, NB; Department of Family Medicine (Dumas-Pilon), McGill University, Montréal, Que.; Department of Family Medicine (Farrell), Memorial University of Newfoundland, St. John’s, NL; Nine Circles Community Health Centre (Ireland) and Department of Family Medicine (Singer), University of Manitoba, Winnipeg, Man.; Université du Québec en Outaouais (Nabelsi), Gatineau, Que.; Providence Health Care (Wilson), Vancouver, BC
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Erin Keely
C.T. Lamont Primary Health Care Research Centre, Department of Family Medicine (Liddy, Crowe), Department of Medicine (Keely), University of Ottawa; eConsult Centre of Excellence (Liddy, Keely), The Ottawa Hospital; Bruyère Research Institute (Crowe); Canadian Foundation for Healthcare Improvement (Drimer, Kirvan), Ottawa, Ont.; New Brunswick Medical Society (Boulay), Fredericton, NB; Department of Family Medicine (Dumas-Pilon), McGill University, Montréal, Que.; Department of Family Medicine (Farrell), Memorial University of Newfoundland, St. John’s, NL; Nine Circles Community Health Centre (Ireland) and Department of Family Medicine (Singer), University of Manitoba, Winnipeg, Man.; Université du Québec en Outaouais (Nabelsi), Gatineau, Que.; Providence Health Care (Wilson), Vancouver, BC
MD
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Article Figures & Tables

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    Figure 1:

    Monthly case volumes for participating programs. See Table 1 for details about the period of data collection for each program. The study analyzed data from June 2017 to December 2018.

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    Figure 2:

    Percentage of cases completed within 7 days of submission, by program (for the 5 programs collecting these data). *Excludes data (for 30 cases) from February 2019.

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    Figure 3:

    Number of specialty groups available from each program (for the 9 programs collecting these data) at first and last month of available data.

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    Figure 4:

    Percentage of cases resolved without the patient needing a face-to-face specialist visit, by program (for the 6 programs collecting these data).

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    Table 1:

    Overview of participating programs

    Program nameService typeDate of program launchDate range for dataNo. of cases completedMean no. of cases/moNo. of specialties available*
    Alberta
     AHS Calgary eReferralBASEJuly 2014August 2017–February 201939820.915
     AHS Calgary Zone Specialist LINKRACEJuly 2014August 2017–November 20186792424.515
    British Columbia
     Fraser RACE TeamRACEJanuary 2014December 2017–November 201840133.410
     Interior EASERACEJanuary 2015December 2017–November 2018612517
     RACE NorthRACEJune 2012October 2017–November 201856740.513
     Providence eCASEBASEApril 2017May 2017–December 201893446.7–
    Manitoba
     BASE eConsult MBBASEDecember 2017December 2017–November 201817614.726
    New Brunswick
     eConsult NBBASEMay 2018May 2018–October 20189716.15
    Newfoundland and Labrador
     NL BASEBASENovember 2016September 2017–November 20181716114.437
    Quebec
     eConsult QuebecBASEMay 2017May 2017–March 2019138960.422
    Saskatchewan
     Saskatchewan LINKRACEMarch 2016May 2017–December 201837718.97
    • Note: AHS = Alberta Health Services, BASE = Building Access to Specialists through eConsultation, RACE = Rapid Access to Consultative Expertise.

    • ↵* At end of the data collection period.

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CMAJ Open: 9 (4)
Vol. 9, Issue 4
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Impact of the Connected Medicine collaborative in improving access to specialist care: a cross-sectional analysis
Clare Liddy, Emma Boulay, Lois Crowe, Maxine Dumas-Pilon, Neil Drimer, Gerard Farrell, Laurie Ireland, Christine (Kirby) Kirvan, Veronique Nabelsi, Alexander Singer, Margot Wilson, Erin Keely
Oct 2021, 9 (4) E1187-E1194; DOI: 10.9778/cmajo.20200210

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Impact of the Connected Medicine collaborative in improving access to specialist care: a cross-sectional analysis
Clare Liddy, Emma Boulay, Lois Crowe, Maxine Dumas-Pilon, Neil Drimer, Gerard Farrell, Laurie Ireland, Christine (Kirby) Kirvan, Veronique Nabelsi, Alexander Singer, Margot Wilson, Erin Keely
Oct 2021, 9 (4) E1187-E1194; DOI: 10.9778/cmajo.20200210
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