Chair's Message – e-Consult

No doubt you have noted the increasing complexity of family medicine care in your practices. You have probably also noticed increasing difficulty in accessing certain specialty services, long wait times for consultations, and patient’s experience with referral to specialists being less than positive.

Advances in technology can be helpful in dealing with these issues. One technological advance that we are using with more frequency in the SWLHIN is e-Consult.

E-Consult allows for a family physician to send a question to a specialist by secure message on the OTN platform and receive an answer back within three days, usually, dramatically shortening the wait time and possibly eliminating the need for face-to-face consultation in as many as 40 per cent of cases. The median response time for specialists in the SWLHIN is 1.1 days.

The e-Consult program has been in place in the SWLHIN for a few years now, but recent data shows that our usage of this program is less than some other LHINs. Currently there are 628 primary care physicians with access to e-Consult via the OTN Hub in the SWLHIN, but only about 120 are actively using the system, ( active user is defined as at least 3 e-Consults requested within a one year period), for a usage rate of 3.05 e-Consults per 1000 population. Compare this with Waterloo Wellington at 5.55 per 1000 or Champlain LHIN with approximately 12 e-Consults per 1000 population. We are not the lowest in the province, but we could make better use of this technology in our own backyard.

Review the following slide presentation for the most up to date information.

There are 55 active specialists on the list in the SWLHIN providing over 3000 e-Consults per year. Dermatology, Hematology, Psychiatry, Endocrinology, Obstetrics, and Gastroenterology are the most common specialities requested in decreasing order.

I recently requested an e-Consult about an abnormal imaging test from an urologist and received the reply within 3 hours, thus avoiding a formal consult and providing relief of anxiety for that patient on the same day. Outstanding service!

I encourage you to start using this service more. It is unfortunate that it is not yet integrated with our EMR but hopefully will be some day. Just keep it in mind as questions arise during your practice day. It is easy to use and there is a billing code for family physicians requesting e-Consults. For more information and to sign up visit

As always I welcome your feedback at or Twitter @DOCSJW.