eCASE

eCASE (electronic Consultative Access to Specialist Expertise) is a novel strategy to enhance patient care, currently in the prototype phase.

For traditional referrals, patients often wait months to see a specialist, however, minor advice may be all that is needed. Conversations are channeled through a web-based platform, and Primary Care Providers (PCPs) are able to attach clinical documents that may help specialists in making a recommendation. The response time for this service is within seven days. An educational interaction with knowledge transfer is encouraged when the specialist answers the call. In the spirit of “capacity building”, specialists are recruited for their interest in teaching and communication as well as their recognition as key opinion leaders. Patients may have their healthcare issue dealt with by their PCP instead of needing to see a specialist. This will often render face-to-face consultation unnecessary.

What kinds of questions should I submit through eCASE?

eCASE is intended for non-urgent patient-care questions. Aside from this requirement, we leave it up to you to determine if your concern can be effectively addressed through eCASE. For example, questions that require physical examination would not be appropriate.

Some appropriate topics for eCASE may be:

  • Questions on medication management: dosing, new therapies, drug interactions;

  • Interpretation of images and test results: x-rays, ECGs, blood tests etc.;

  • Reassurance of your existing care plan;

  • Interim management options while waiting for a specialist consultation.

Can I bill for using eCASE?

There are no MSP fees for family physicians to bill for eConsultation. There is a $11.07 fee code (G10005) enabling specialists to bill for email advice; however we are remunerating specialists $60 per consult to answer questions. Specialists cannot bill the MSP fee when providing advice through eCASE.

What about patient privacy?

The dr2dr system is fully secure; the patient information you submit through this system is always safe. However, take care to direct your question to the intended eCASE Inbox, and make sure to delete any patient documents you save on your computer when submitting a question or importing the answer into your Electronic Medical Record.

Key benefits

  • Patients do not need to visit with more than one healthcare practitioner when eCASE is part of the solution.

    • Upon further scale-up, access to many differing specialty areas will be advanced through eCASE.

    • Family physicians develop deeper knowledge on their patients’ conditions through repeated use of eCASE.

  • For appropriate non-urgent cases, eCASE provides a more cost-effective method of initiating treatment when compared to traditional referrals.

    • eCASE provides a new channel for communication and problem-solving between family physicians and specialists; relationships are developed and strengthened over time.

    • Avoiding the travel and wait-times associated with a specialist visit.

    • The timelier initiation of treatment or diagnostics.

    • Having their care delivered by the provider that they are most used to.

    • More effective specialist visits if action can be taken in anticipation of the appointment.

    • Reducing specialty wait-lists across the system, improving specialists’ capacity to see necessary cases in person.

    • Access to a flexible model of co-managing patients, allowing specialists to address questions at their convenience (within 7 days).

    • eCASE provides a way for family physicians to be updated on the newest treatments, therapies, and health services relevant to the specialty area in question.

    • Specialists are remunerated providing advice on managing patient care.

    • eCASE acts as a resource to direct your patient’s care, expanding family physicians’ functional scope of practice to deliver care in the communities where patients reside.

    • Knowledge is translated from specialists to family physicians through using this service over time, improving family physicians’ ability to address patient care needs.

    • Being updated on the newest treatments, therapies, and health services within participating specialty areas.

Helpful links

Unanswered consults?

If you submit a question through eCASE and do not receive an answer back within one week, please contact us at ecase@providencehealth.bc.ca.

All unanswered questions will be followed up.

eCase specialty areas

  • Addictions Medicine

  • Adult Psychiatry

  • Cardiology

  • ENT

  • Gastroenterology

  • General Internal Medicine (Rural)

  • General Internal Medicine (Urban)

  • General Internal Medicine—COVID-19 Long-Term Sequelae

  • Geriatric Medicine

  • Hand and Upper Limb Orthopedics

  • Heart Rhythm

  • Infectious Diseases—Tropical Medicine and Parasitology

  • Interventional Radiology

  • Medical Assistance in Dying (MAiD)

  • Medical Imaging

  • Medical Termination of Pregnancy

  • Neurology

  • Ophthalmology

  • Otology—Hearing, Balance, and Ear Disease

  • Pediatric Gastroenterology

  • Pediatric Rheumatology

  • Pediatrics

  • Respirology

  • Rheumatology

  • Stroke

  • Thrombosis

  • Transgender Care