P-16: E-Consultation: Building Capacity for Spinal Cord Injury Primary Care
James Milligan, Joe Lee, Cathy Craven, Dalton Wolfe, Craig Bauman
Introduction and Aims: Community care of patients with spinal cord injury (SCI) is challenging and could be improved with timely access to SCI specialists. This pilot study explored the feasibility of using an e-consultation service to link family physicians with physiatrists to improve family physician access to timely advice regarding SCI care.
Methods: Mixed methods study using questionnaires and interviews. Sixteen family physicians, and two physiatrists were recruited. Family physicians could access physiatrists using a secure e-consultation system. Following pilot testing, participants were invited to complete an on-line survey, using 5-point scales (1 = not at all, 5 = extreme positive) to rate various aspects of the service, and to participate in individual interviews to obtain their perceptions of the service.
Results: Surveys were completed by 8/16 physicians (44%) and 11/16 (61%) completed an interview). Fourteen e-consultations were completed, most frequently for bladder (n=4) and bowel issues (n=4). Mean ratings reflected that the e-consultation process was prompt (M=4.0), helpful (M=3.8), and relevant (M=3.6); physicians were moderately satisfied with the service (M=3.8). Interview analysis generated six themes: (i) improved access to SCI expertise for family physicians, (ii) avoidance of specialist referrals and emergency department visits, (iii) easy and convenient use, (iv) secured system for sharing patient information, (v) use facilitated by dedicated resource support, (vi) system (technological) constraints/limitations.
Conclusions: A SCI specific e-consultation service can provide family physicians with timely access to advice not otherwise easily accessed to facilitate the management of SCI health issues at a primary care level.