eConsultation between health care professionals in primary health care and specialized medical care

Abstract

The synchronous eConsultation is provided by a specialist in a hospital to a GP appointment either by pre-set request or without scheduling. The patient participates in the session. The eConsultation employs video or chat and the program integrated into Health Village service platform enables also sharing x-rays, still photos and other EHR material. Health Village delivers public health services for general public, digital care pathways for patients with specific diagnoses and digital tools for professionals.The eConsultation project started in 2018, after interviewing the member municipalities (n = 24, 1 600 000 inhabitants) of the Hospital District of Helsinki and Uusimaa (HUS) in Finland. The municipalities gave a high priority to eConsultation as a way of further integration of service chains and dissemination of common practices between and within the specialized and primary health care services.Funded by the HUS and supported by the HUS IT Department eHealth Services, eConsultation pilots started in 2018 in close collaboration between the public specialized and primary health care organizations in neurology, orthopedics and wound treatment. The pilots indicated that eConsultation are more efficient than traditional consultation methods (e.g., the time used by a neurologist in eConsultation dropped by 87% vs. a face-to-face consultation visit). Almost all of patients and 84% of primary care professionals reported high level of satisfaction. The consultants found that the presence of a patient fostered, if needed, additional clinical interview and diagnostic procedures by proxy, as well as assessment of individual needs of a GP. The primary care professionals appreciated queue-free response (45 seconds in eConsultation with no pre-set appointment time) and augmented educational validity.Scaling of eConsultation across the whole hospital district and more specialties is going on. eConsultation will be explored in depth in two starting scientific studies.