Effect of implementation of an electronic consult referral platform (eConsult) to triage retina referrals in Manitoba.

Abstract

Objective: eConsult allows specialists to diagnose and recommend treatment plans for nonurgent conditions without the need for patient travel. Our purpose is to evaluate the effectiveness of eConsult in reducing unnecessary in-person retinal consultations in Manitoba.

Design: Retrospective eConsult chart review.

Participants: Any person for whom an eConsult was submitted for a retina problem in Manitoba between November 2020 and October 2023 (n = 196).

Methods: The primary objective was to quantify eConsults requiring no in-person referral, routine in-person referral, or urgent (within 4 weeks) in-person referral. Secondary objectives included describing characteristics of eConsults and quantifying the amount of time spent on the platform by both the referring provider and the specialist. On the basis of these variables, patient travel, consultation time, and specialist billings savings were calculated.

Results: 66.8% of eConsults did not require in-person assessment (n = 131), 24.5% required to be seen on a routine basis (n = 48), and 8.7% required to be seen within 4 weeks (n = 17). This translated to a net cost of $2,660.43 for the provincial government in billings over 3 years, but 81 990 km saved in patient travel. 99% of eConsults came from optometrists (n = 194). Referring providers spent an average of 10.6 ± 9.4 minutes on the platform per referral, and the specialist consultant spent 9.1 ± 6.6 minutes.

Conclusion: eConsult is a potentially cost-effective way to address increasing demand for retinal services, reduce wait times by reducing unnecessary referrals, and facilitate data sharing between optometrists and ophthalmologists.