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Australian Journal of Primary Health Australian Journal of Primary Health Society
The issues influencing community health services and primary health care
RESEARCH ARTICLE (Open Access)

Supporting complex care in general practice via an eConsultant model of care: the Australian specialist perspective

Joel Petre https://orcid.org/0000-0001-6365-8801 A * , Maria Donald A and Claire Jackson A
+ Author Affiliations
- Author Affiliations

A UQ Centre for Health System Reform and Integration, University of Queensland, Brisbane, Qld 4006, Australia.

* Correspondence to: j.petre@uq.edu.au

Australian Journal of Primary Health 29(5) 455-462 https://doi.org/10.1071/PY22243
Submitted: 14 November 2022  Accepted: 11 April 2023   Published: 15 May 2023

© 2023 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of La Trobe University. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)

Abstract

Background

Accessing timely specialist physician advice and guidance is of critical importance to both Australian GP specialists (GPs) and their patients. The traditional method of referral, triage and subsequent face-to-face (FTF) consultation is facing challenges from an ever increasing volume of referrals and the needs of underserved populations. In response to such issues, electronic consults (eConsults) have been successfully used internationally to provide GPs with a means of asynchronously accessing specialist physician advice and guidance within 72 h. Few studies have addressed the potential impact of eConsults from the view of the non-GP specialist receiving the request, and none specifically related to specialist adult medicine physicians. The aim of this study was to determine the perceptions of current Royal Australasian College of Physicians (RACP) adult medicine Fellows towards establishing an eConsult model of care within their own clinical practice.

Methods

Semi-structured interviews were conducted with 14 RACP adult medicine Fellows between December 2019 and February 2020. Purposive and snowball sampling strategies were used to recruit physicians of differing ages and gender from diverse specialties and healthcare settings. The data were subjected to a descriptive thematic analysis.

Results

We describe five key themes of relevance to study participants: (1) improved access to non-GP specialist care; (2) the business model in relation to remuneration and time; (3) enhanced GP–Physician relationships; (4) impact on physician work–life balance; and (5) the need for a structured model of care. There was broad consensus that a significant number of outpatient referrals to adult medicine physicians would be more appropriately addressed in primary care with support via an asynchronous eConsult arrangement. RACP Fellows agreed this could improve access to timely specialist advice, place downward pressure on outpatient FTF clinic waiting times and reduce unnecessary patient travel.

Conclusion

These findings identify the drivers and barriers to the establishment of an Australian eConsultant model of care from the adult medicine physician’s perspective.

Keywords: advice and guidance, digital health, eConsult, eConsultant, eHealth, eReferral, online consult, Telehealth.

References

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