Background: In 2017, the Canadian Foundation for Healthcare Improvement launched the Connected Medicine collaborative to support the implementation, spread and adaptation of 2 innovative remote consult solutions - the Champlain Building Access to Specialists through eConsultation (BASE) eConsult service and the Rapid Access to Consultative Expertise (RACE) service - across Canada. We evaluated the impact of the programs implemented through the collaborative.
Methods: We conducted a cross-sectional analysis of data from provincial teams that participated in the Connected Medicine collaborative, which took place between June 2017 and December 2018 in 7 provinces across Canada (British Columbia, Alberta, Saskatchewan, Manitoba, Quebec, New Brunswick, Newfoundland and Labrador). Data included utilization data collected automatically by the BASE and RACE services and, where available, responses to surveys completed by primary care providers at the end of each case. We assessed programs on the following outcomes: usage (i.e., number of cases completed, average specialist response time), number of specialties available, impact on primary care provider's decision to refer and impact on emergency department visits. We performed descriptive analyses.
Results: Ten provincial teams participated in the collaborative and implemented or adapted either the RACE service (4 teams), the BASE service (5 teams) or a combination of the 2 services (1 team). Average monthly case volume per team ranged from 14.7 to 424.5. All programs offered multispecialty access, with specialists from 5 to 37 specialty groups available. Specialists responded to eConsults within 7 days in 80% ( = 294/368) to 93% ( = 164/176) of cases. Six programs provided survey data on avoidance of referrals, which occurred in 48% ( = 667/1389) to 76% ( = 302/398) of cases. Two programs reported on the avoidance of potential emergency department visits, noting that originally considered referrals were avoided in 28% ( = 138/492) and 74% ( = 127/171) of cases, respectively.
Interpretation: The 2 innovative virtual care solutions implemented through the Connected Medicine collaborative received widespread usage and affected primary care providers' decisions to refer patients to specialists. The impact of these models of care in multiple settings shows that they are an effective means to move beyond the pilot stage and achieve spread and scale.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8687491 | PMC |
| http://dx.doi.org/10.9778/cmajo.20200210 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Multi-level Factors to Build Confidence and Support in Active Surveillance for Low-Risk Prostate Cancer: A Qualitative Study.
J Gen Intern Med
January 2025
Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA.
Background: Active surveillance (AS) is the guideline-recommended treatment for low-risk prostate cancer and involves routine provider visits, lab tests, imaging, and prostate biopsies. Despite good uptake, adherence to AS, in terms of receiving recommended follow-up testing and remaining on AS in the absence of evidence of cancer progression, remains challenging.
Objective: We sought to better understand urologist, primary care providers (PCPs), and patient experiences with AS care delivery to identify opportunities to improve adherence.
A genome-wide atlas of human cell morphology.
Nat Methods
January 2025
Broad Institute of MIT and Harvard, Cambridge, MA, USA.
A key challenge of the modern genomics era is developing empirical data-driven representations of gene function. Here we present the first unbiased morphology-based genome-wide perturbation atlas in human cells, containing three genome-wide genotype-phenotype maps comprising CRISPR-Cas9-based knockouts of >20,000 genes in >30 million cells. Our optical pooled cell profiling platform (PERISCOPE) combines a destainable high-dimensional phenotyping panel (based on Cell Painting) with optical sequencing of molecular barcodes and a scalable open-source analysis pipeline to facilitate massively parallel screening of pooled perturbation libraries.
View Article and Find Full Text PDFASIC1a mediated nucleus pulposus cells pyroptosis and glycolytic crosstalk as a molecular basis for intervertebral disc degeneration.
Inflamm Res
January 2025
Department of Orthopedics and Traumatology, The Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou, Sichuan Province, China.
Background: One of the etiologic components of degenerative spinal illnesses is intervertebral disc degeneration (IVDD), and the accompanying lower back pain is progressively turning into a significant public health problem. Important pathologic characteristics of IVDD include inflammation and acidic microenvironment, albeit it is unclear how these factors contribute to the disease.
Purpose: To clarify the functions of inflammation and the acidic environment in IVDD, identify the critical connections facilitating glycolytic crosstalk and nucleus pulposus cells (NPCs) pyroptosis, and offer novel approaches to IVDD prevention and therapy.
Genetic coupling of enhancer activity and connectivity in gene expression control.
Nat Commun
January 2025
MRC Laboratory of Medical Sciences, London, UK.
Gene enhancers often form long-range contacts with promoters, but it remains unclear if the activity of enhancers and their chromosomal contacts are mediated by the same DNA sequences and recruited factors. Here, we study the effects of expression quantitative trait loci (eQTLs) on enhancer activity and promoter contacts in primary monocytes isolated from 34 male individuals. Using eQTL-Capture Hi-C and a Bayesian approach considering both intra- and inter-individual variation, we initially detect 19 eQTLs associated with enhancer-eGene promoter contacts, most of which also associate with enhancer accessibility and activity.
View Article and Find Full Text PDFInterviews to Assess a Peer Health Navigator Service for People Who Are Transgender or Gender Diverse.
Ann Fam Med
January 2025
University of Saskatchewan, School of Rehabilitation Sciences, Saskatoon, Saskatchewan, Canada
Purpose: People who are transgender or gender diverse (PTGD) often experience difficulties navigating the health care system due to a variety of factors such as lack of knowledgeable and/or culturally competent clinicians, discrimination, and structural and/or socioeconomic barriers. We sought to determine whether a peer health navigator service in the Canadian province of Saskatchewan helped connect transgender and gender-diverse clients and health care practitioners (HCPs) to resources, and how this service changed their health care experiences.
Methods: Semistructured interviews were conducted with 9 clients and 9 HCPs.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!