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eConsult Frequently Asked Questions - eConsult

 

1. How can I access eConsult?

eConsult is open to primary care physicians and nurse practitioners practicing across Ontario. Please contact your OntarioMD Practice Advisor or email support@ontariomd.com for additional information and next steps. If you are a specialist interested in participating, please contact the Ontario eConsult Centre of Excellence at eConsultCOE@toh.ca for additional information and next steps.


2. What are the next steps after I contact OntarioMD to participate in eConsult?

Getting set up on eConsult involves a simple two-step sign-up process:

Step 1: After you advise OntarioMD of your interest in participating, an OntarioMD Practice Advisor will contact you to collect the information needed for eConsult enrollment: your name, address and contact info; your CPSO or CNO number; and your ONE® ID username, if you have one. Once your information is verified, you will be contacted within three business days to schedule an in-person appointment to complete your eConsult registration.

Step 2: At the in-person meeting, the Practice Advisor will guide you through the OTN eConsult registration process, including setting up your ONE ID account, if applicable. Once you are set up, you’ll be trained on how to use OTN eConsult. The entire meeting should take about 30 minutes.


3. Is eConsult accessible through my EMR?

eConsult is currently available through Accuro EMR and OSCAR as part of OntarioMD’s eConsult EMR Integration initiative. OntarioMD is in the process of enhancing access to eConsult through EMRs to include the BASE Managed Specialty Service. An updated EMR specification will be available for all OntarioMD-certified EMR vendors in Spring 2019. This specification will define the requirements for integrating with the Ontario eConsult Program. In the interim, as OntarioMD completes the EMR integration, we continue to encourage clinicians to leverage the service available through OTNhub.

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4. Can a physician assistant or allied health professional request an eConsult?

Presently, only family physicians and nurse practitioners can request eConsults. Ontario Telemedicine Network (OTN) eConsult does, however, allow family physicians to designate delegates. Delegates can be any staff that primary care clinicians or specialists choose to use eConsult on their behalf. A delegate for a requesting clinician may send eConsults on behalf of one or multiple requesting clinicians; they are able to select the clinician on behalf of whom they are sending the eConsult when they draft the eConsult request. Specialist delegates can respond to eConsults on behalf of the specialist. Email notifications are delivered to both the clinician and delegate unless either of them opts out of receiving them. The only difference between a delegate user and a requesting primary care provider or specialist is that requesting primary care providers and specialists are ultimately responsible for their delegates’ use of the system.

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5. How are family physicians, nurse practitioners and specialists compensated for using the Ontario eConsult Program?

Services that are part of the Ontario eConsult Program are available at no cost to the patient and the provider. Where applicable, family physicians can bill OHIP for the consult request using the K738 fee code (Ontario Schedule of Benefits). A K738 Clarification Guide has been published by the Ontario Medical Association Economics Department to assist physicians in correctly using the code. Specialists providing services on eConsult are paid an hourly rate of $200, pro-rated based on the length of time it takes to complete an eConsult. Remuneration for services rendered will be reimbursed by the Ontario eConsult Centre of Excellence effective October 1st, 2018. 

If you have any questions about specialist remuneration, please contact the Centre of Excellence at eConsultCOE@toh.ca. Dermatologists and ophthalmologists providing specialist services on eConsult must bill the OHIP U-Codes (U025, U023, U026 and U021), for virtual e-assessment services rendered. Remuneration for services rendered by dermatologists and ophthalmologists will not be reimbursed by the eConsult Centre of Excellence and must be billed directly to OHIP.

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6. What is the difference between an eConsult and an eReferral?

An eConsult differs from an eReferral in that the patient does not have a face to face visit with the specialist. The patient's condition is discussed between the patient's primary care provider (family physician or nurse practitioner) and the specialist. With an eReferral, the patient goes to the specialist for an initial consultation after the primary care provider sends the specialist the referral information.



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7. What are the similarities between an eConsult and an eReferral?

Both eConsult and eReferral are electronic tools or services aiming to improve access to specialty care, and to automate the workflow between primary care providers and specialists. The benefits of both services are reduced wait time for specialist consultation and improved patient care.


8. What is the CMPA's position on using eConsult to provide patient care?

The Canadian Medical Protective Association (CMPA) has assessed the eConsult flow of care and determined that it provides an opportunity to improve efficiency, enhance patient care, expand access to specialists and provide a clear audit trail of the specialist's advice given to the requesting clinician for the suggested care of the patient. For more information on the CMPA's eConsult position, please review the CMPA Assessment.

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