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Specialist Best Practice Guide

Responsibilities as an eConsult Specialist

Provide collegial and educational responses

Respond to eConsults within 7 days 

Provide dates you are unavailable to provide eConsults to the eConsult support team

Maintain up to date contact information with the eConsult support team

Provide and maintain up to date payment information to the eConsult Centre of Excellence

Providing an eConsult Response

  • Provide a collegial and education response to requesting clinicians based on information provided.

  • Request more information from requesting clinician when sufficient information is not provided.

  • If request would be more appropriately addressed by a traditional referral, make this suggestion to the requesting clinician. You may offer to have the patient seen at your clinic, but you are not obliged to do so, nor is the requesting provider obliged to refer their patient to your clinic.

  • Provide advice even when a traditional referral would be ideal, such as: steps that could be taken while awaiting traditional referral, or other management options if traditional referral is not an option (ex: rural patient, mobility challenges, etc).

  • Requesting clinicians may respond to your initial advice with additional information and/or follow-up question(s).

  • If you have any questions or concerns about a particular case or in general, you can reach out for support from eConsultSupport@lhinworks.on.ca.

10 Key Elements of a High Quality eConsult Response

1. Current, up to date advice that is evidence based where applicable

7. Specific advice as to when a face-to-face referral would be indicated

2. Advice that is helpful and educational, including rationale or evidence for recommendations

6. Recommendations that include anticipatory guidance such as what key features would prompt further workup and what to try next if recommendations aren't effective

3. Patient-specic recommendations rather than general guidelines

4. Each question is addressed

5. Specific recommendations. For example, including cost and availability of tests or treatment that is recommended, doses/titration of recommended medications

8. Recommendations that are actionable by the requesting provider (e.g. local resources) are available if needed

9. Clear, organized responses that ensure key information is easy to find

10. A professional and supportive tone that invites further back and forth  communication where appropriate

Keely, E. and Liddy, C. (2020) Specialist participation in eConsult and eReferral Services: best practices. Telemed e-Health. Available at: http://doi.org/10.1089/tmj.2020.0023

Tran C, Archibald D, Humphrey-Murto S, Liddy C, Keely E. What Makes a High Quality eConsult? A Nominal Group Study. J  Telemed Telecare. 2019 Feb 4:1357633X18822885. doi: 10.1177/1357633X18822885. [Epub ahead of print]

Specialist Remuneration 

  • Billing time should include review of all patient information and provided materials, composition of reply and any routine review of treatment and care, as needed. Billing time should not include extensive literature review, consulting with other colleagues or an extensive chart review. These activities can be included in personal learning projects and submitted to the RCPSC or CFPC for MOC credit. 

  • Paid an hourly rate prorated to 5-min increments up to 20 minutes, and to 1-min increments from 26 to 60 minutes. 

  • Based on self-reported billing time input directly on platform after completing each eConsult response. 

  • Maximum billing time of 60 minutes per eConsult response. 

  • Paid out directly by Ontario eConsult Centre of Excellence, housed at The Ottawa Hospital on a quarterly basis. 

  • Payments are released at the end of the month following the end of each quarter (Jan-Mar, Apr-Jun, Jul-Sep, Oct-Dec). 

  • Contact eConsultAdmin@toh.ca for remuneration related inquiries. 

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For more information about specialist remuneration, see our FAQ page and Payment Policy Brief. 

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