Table 1.

The Champlain Building Access to Specialists through eConsultation Service's Impact Viewed Through the Lens of the Quadruple Aim Framework

Aim	Outcome	Measure	eConsult Impact
Patient Experience	Wait times	Usage data	Responds to previously articulated patient dissatisfaction with wait times²²
	Patient satisfaction	Interviews	Patients deem useful in 86% of visits, acceptable alternative to traditional referrals in 97%²³
	Response time	Usage data	Median response time of 1.2 days (interquartile range, 0.2 to 4.2)
	Referral avoidance	Usage data	71% of cases resolved without need of a face-to-face specialist referral
Provider Experience	PCP satisfaction	Closeout survey	PCPs rank eConsult as high/very high value in 94% of cases²⁵
	Educational value	Closeout survey	92% of cases ranked as high/very high educational value.
	Specialist satisfaction	Surveys	94% of specialists report eConsult improves communication with PCPs²⁶
Costs	Total system costs	Cost data	Total system costs over 2014 to 2015 fiscal year were $207,680²⁷
	Per capita cost	Cost data	Weighted average of $47.35/case versus $133.60/case for traditional referrals²⁷
	Direct and indirect savings	Estimate of resource utilization, patient costs, etc.	Accounting for societal factors (eg, avoided referrals and patient expenses) yields additional savings of $11/case²⁸
Population Health	Health outcomes (eg, mortality, morbidity, and health status)	Health administrative data, randomized controlled trials	Unable to assess
	Provider adoption	Usage data	1299 PCPs have enrolled with the service
	Population served	Usage data	28,838 cases completed, average monthly case volume increased from 13 in 2011 to 969 in 2017
	Provider utilization	Usage data	61% of enrolled PCPs have used the service in the last 12 months
	Patient safety	Usage data	eConsult prompts a referral in 3.4% of cases, potentially improving patient safety³¹