eConsult BASE with the Bruyère Research Institute, Long-Term Care

Residents of Ontario’s long-term care homes are some of the province’s most medically complex and frail patients.

The COVID-19 pandemic serves as a tragic reminder of just how vulnerable our long-term care residents are. Prior to the pandemic, they were already experiencing excessive wait times for specialist appointments for multiple reasons including physical, behavioural and financial, with many struggling to manage the costs associated with travel to appointments — and as a result, often receiving specialist care only in urgent or emergency situations.

eConsultBASE™ (Building Access to Specialists through eConsultation), a solution to the problem, brings together physicians, caregivers and researchers with one common goal: to improve access to timely specialist advice for residents living in long-term care. This is even more important in a pandemic and post-pandemic environment.

Patient perspectives and patient-centred care are at the heart of eConsultBASE™. The service was built in response to clearly articulated patient dissatisfaction around wait times and informed by interviews with patients. The Bruyère Research Institute’s team, in collaboration with the eConsult Centre of Excellence at the Ottawa Hospital and the Champlain BASE eConsult team, has been committed to a patient/caregiver co-design approach, encouraging both groups to participate in each stage of research and implementation.

A secure, web-based tool, eConsult breaks down barriers within the healthcare system, connecting physicians and nurse practitioners with timely access to specialist advice on behalf of their patients. Physicians and nurse practitioners submit a clinical question to a specialty group (i.e., cardiology). The case is then assigned to a specialist who, on average, responds in 1.2 days. Two-thirds of cases are resolved without the patient needing an in-person specialist visit. The eConsult service is available at no cost to the patient or provider.

First launched in 2010 in the Champlain health region, eConsult is now available across Ontario. As we redefine what health care and access to long-term care looks like post-pandemic, this tool is an important solution that has already been proven to significantly enhance the healthcare experience for providers, residents, family members and caregivers.

eConsult transforms the referral-consultation landscape in long-term care, and it can be a game-changer in a new pandemic environment, where most long-term care residents will not have the option to travel from their home.