June 2022

In this issue:

• Dermatology - eConsult Image Requirements 
• eConsult and eReferral - Globe and Mail Article
• Attaching Files to eConsult 
• Accredited eConsult Webinar Series
• Ontario eServices Program: eReferral 
• Book an eConsult Training Session 

Specialist expertise at your fingertips

Consider an eConsult before you refer

By choosing an eConsult, you can increase speed of care and decrease the likelihood of an adverse health event for patients during their wait to see their Specialist. 

You can send any eConsult to a Specialist to seek advice on:

• If a referral is required
• What tests to order in preparation for your patient’s Specialist visit 
• How to manage your patient's care while they wait to see a Specialist
• Confirm a proposed treatment plan
• Get recommendations for medications

Dermatology eConsult Image Requirements

Diagnosis in Dermatology is a very visual skill and requires high quality images. Providing an opinion on therapeutic options also often requires pictures to be sure the diagnosis is accurate. If the image quality is poor, for example, not in focus, poorly lit or too close to assess the extent of a problem, the ability of the dermatologist to give a high quality, definitive response is severely limited. It may mean bringing the patient back for more photos, so best to do it right the first time! 

We encourage every PCP to consider the following guidelines for all Dermatology eConsults: 

1) Include at least one image and usually more than one. If it is purely a therapeutic question an image is still helpful to allow the dermatologist to confirm the diagnosis before recommending treatment. 

2) Check all images in the review mode of the camera before uploading onto the eConsult platform. It is best to review these images at a magnified or telephoto setting on your camera to be sure they are sharply focused. Also ensure you transfer the original image, not a compressed image, from your camera device to the device you use to access eConsult (“compressing” the photo in the transfer process reduces resolution/sharpness of the image). 

3) Include close up photos of individual lesions and images of the affected areas. A photo that illustrates the overall distribution of the lesion(s) is also recommended to facilitate diagnosis. All images must be sharply focused and well lit. 

4) Place a white paper ruler in the same plane as the lesion. This gives the size plus the cameras easily focus on the white paper and it actually gives a white balance reading as well. 

5) Patient provided photos must meet the same standards or we will not be able to provide quality service or possibly no service at all. The PCP should review patient photos before uploading, and if they are not up to standard, photos should be re-taken. 

Thank you for taking the time to take photos that are sharply-focused, well-lit and which show the location and distribution of the patient’s lesions. Together we can convert a very good service into an excellent service.

eConsult and eReferral - Globe and Mail 

OPINION 

Canada's specialist referral system needs to be boosted into the 21st century

GLOBE AND MAIL

PUBLISHED MAY 14, 2022

“E-referral and e-consult systems not only make care faster and better, but they can also help us to better understand wait times, and the health system as a whole, by increasing our collection of digital data. Governments and ministries can gain valuable insight from the data provided by e-referral and e-consultation requests, allowing administrators to properly plan for health human resources where they’re needed most and eliminate bottlenecks.”

A Globe and Mail reader weights in:

To read the full Globe and Mail article, click here.

Attaching Files to your eConsult question

You can attach multiple files to your case. For each attachment you should include a brief but meaningful description. Ensure that the recipient has the right software for viewing the attached files. 

Notes:

(1) The attachment must be a valid file type. eConsult does not accept ‘unsafe’ file types such as .exe, .vbs, .tmp, etc. 

(2) Maximum file size is 500 MB.

(3) There is no space/storage limit per user or per case. 

If you have image files or other report files to include with your case/consult notes, do either of the following: 

• Click the paperclip link at the bottom of the ‘Enter notes’ area, navigate to the file location and select the desired file.

OR

• Using Windows Explorer (or Mac Finder), navigate to the file location, select the file and drag and drop the desired files into the dashed-line square under the ‘Enter notes’ area. 

For each file attached, eConsult checks that it is a valid file type, is within size limits and performs a virus scan. (A progress bar appears as these steps are completed. 

1. For each attached file, click in the text field just below the file name and enter a short but meaningful description. 
2. To remove a listed file, click the X at the far right of the designated file. (For example, if after selecting a file, you realize you made a mistake and want to select a different file.)

The list of attached files refreshes and reappears without the selected file and a success message briefly appears. 

eConsult automatically saves a draft of the case as you add file attachments. 

Note: File attachments with a comma in the name will not open in Google Chrome.

List of types of attachments that work available here

Accredited eConsult Webinar Series

Join us for 8 half-hour sessions about the benefits of eConsult in your practices. Receive up to 4 credits from the College of Family Physicians and the Royal College!

Watch Session 1 Recording

Session 1: Pediatrics and eConsults with Dr. Richard van Wylick

Friday, January 14, 2022 8:30 - 9:00 a.m

Dr. Richard van Wylick is an Associate Professor in General Pediatrics and Associate Dean, Professional Development in Queen's Health Sciences. His research interests are in medical education and clinical studies in pediatrics.

Watch Session 2 Recording

Session 2: Endocrinology and eConsults with Dr. Robyn Houlden

Friday, February 4, 2022 8:30 - 9:00 a.m

Dr. Robyn Houlden is the Division Chair of Endocrinology at Queen's and is a consultant in adult endocrinology at Kingston General and Hotel Dieu Hospitals. She has served on several committees related to diabetes research and reform. 

Watch Session 3 Recording

Session 3: Cardiology and eConsults with Dr. Cathy McLellan

Friday, February 25, 2022 8:30 - 9:00 a.m

Dr. Cathy McLellan is the Division Chair of Cardiology at Queen's and is an interventional cardiologist and clinical lead, percutaneous coronary interventions, both at Kingston General Hospital. 

Watch Session 4 Recording

Session 4: Gastroenterology and eConsults with Dr. Lawrence Hookey

Friday, March 25, 2022 8:30 - 9:00 a.m

Dr. Lawrence Hookey is the Division Chair of Gastroenterology at Queen's and Medical Director of the Endoscopy Units at Kingston General and Hotel Dieu Hospitals. His practice includes general GI with a focus on therapeutic endoscopy and pancreatic and biliary disease.

Watch Session 5 Recording

Session 5: Hematology and eConsults with Dr. David Lee

Friday, April 8, 2022 8:30 - 9:00 a.m

Dr. David Lee is an Associate Professor in Hematology at Queen's and he is the Chair of the Department of Medicine Morbidity and Mortality Rounds and Director of the Anticoagulation Management Service. His practice includes benign and malignant conditions across ambulatory and inpatient settings. 

Watch Session 6 Recording 

Session 6: Urology and eConsults with Dr. Michael Leveridge 

Friday, April 29, 2022 8:30 - 9:00 a.m

Dr. Michael Leveridge is an Assistant Professosr in the Department of Urology and is the Residency Program Director for the Urology training program. His clinical focus is urologic oncology and research focus is population-level research in bladder cancer and testicular cancer outcomes. 

Watch Session 7 Recording

Session 7: Neurology and eConsults with Dr. Albert Jin

Friday, May 27, 2022 8:30 - 9:00 a.m

Dr. Albert Jin is an Associate Professor in Neurology at Queen's and a specialist in cerebrovascular disease. He is the Medical Director for the Regional Stroke Network of Southeastern Ontario. 

Watch Session 8 Recording

Session 8: Child & Adolescent Psychiatry and eConsults with Dr. Sarosh Khalid-Khan

Friday, June 10, 2022 8:30 - 9:00 a.m

Dr. Sarosh Khalid-Khan is a staff psychiatrist in the Division of Child and Youth Psychiatry at Queen's University. She has been at Queen's University since 2008 and has been in several clinical and administrative roles. She specializes in management of complex psychiatric presentations in children and youth, psychopharmacology, and family therapy. 

Ontario eServices Program: eReferral

The Ontario E services program delivers digital services that support clinical workflows and facilitate smoother transitions in care and an improved patient experience. eConsult and eReferral are the first initiatives in the scope of the Ontario eservices program.

eReferral is a secure and seamless transfer of patient information from one point of care system into another, via an electronic platform for the purpose of engaging another provider in the care of a patient.



• The program is funded to provide local change management resources to support implementation, training, adoption, and sustained use
• The solution-generated data enables comprehensive analytics to support local and system level decision making
• Referral status and appointment details are updated directly in providers EMRs (Telus PS Suite EMR, Accuro EMR and Oscar EMR) or the Ocean Portal (non-EMR users)
• Patients received automatic email notifications on their referral status and appointment information
• This eReferral initiative has been funded since 2017 as part of the System Coordinated Access Program (now part of the Ontario eServices Program)

Looking for more information? Contact us at DigitalHealth@transformsso.ca

Why Set your eConsult Priority Regions?

• Setting your priority region to Erie St Clair gives access to local Specialists within the Erie St Clair regional based managed specialty groups automatically
• Without setting priority regions, cases can only be sent to provincial groups



Book a Team Training Session

Are you part of or run a family practice, community health centre or hospital unit? Reach out to us today to book a group training session for your fellow staff.

We can cover:

• How to create an OTNHub account
• How to submit any eConsult directly to a Specialist
• How to submit any eConsult to an Erie St. Clair Regional Specialty Group
• How to utilize a delegate to save time

Email us at digitalhealth@tranformsso.ca to book your session today.

Contact Us

For more information on anything in this email, or to schedule a follow-up appointment with our team, please contact us at the email listed below.

Darren Hopper

Windsor / Essex

Change Management and Adoption Coordinator

Darren.Hopper@transformsso.ca

Matthew McAvoy

Chatham-Kent / Sarnia-Lambton

Change Management and Adoption Coordinator

Matthew.McAvoy@transformsso.ca

Resources:

https://econsultontario.ca/resources/