Examination of Plastic Surgery Clinical Questions and Responses via an Electronic Consultation (eConsult) Service.

Abstract

Introduction: Average wait times for plastic surgery depend on priority, but access to specialist consultation can be upwards of 1-2 years for elective referrals. The Champlain eConsult BASE™ system was developed in 2010 and is a PHIPA-compliant system that allows primary care providers to electronically send specialists questions about specific patients, potentially avoiding the need for a formal in-person consultation. Methods: Electronic Consults (eConsults) through the Champlain eConsult BASE™ system to plastic surgery from January 2021 to December 2022 were assessed by 2 reviewers. A standardized data extraction form was used, categorizing consults for question type and clinical problem. A mandatory close-out survey allowed for analysis on referring physician satisfaction, referral outcome, and impact on patient care. Results: Three hundred and thirty-one eConsults were included and were answered in an average of 2.1 ± 3.1 days. Specialists spent a mean of 14.0 ± 5.7 minutes per case. The most common content of the consults was related to hand trauma (37%), non-hand skin/soft tissue lesions (13%), and hand masses/lesions (bony or soft tissue) (8%). A formal consultation was avoided in 32%. Thirty-nine percent of cases resulted in a change in management: a referral to plastic surgery was avoided but originally contemplated by the family physician in 32%, and a referral was recommended but not originally contemplated in 7%. Conclusions: Our study demonstrates the potential of eConsults to facilitate timely consultation and avoid unnecessary formal consultations with plastic surgeons. This may reduce wait times and improve access to plastic surgeon services.