Improving access to specialist care in correctional facilities through Ontario eConsult

by Danica Goulet, Claire Sethuram, Erin Keely, Clare Liddy

Objectives

To evaluate the accessibility of multispecialty advice for primary care providers (PCPs) within correctional facilities, catering to the healthcare needs of individuals in federal custody in Ontario, Canada, through the utilization of electronic consultation (eConsult).

Design

Retrospective, cross-sectional, descriptive analysis.

Setting

eConsults submitted by PCPs within federal correctional facilities through the Ontario eConsult Service between April 1st, 2019, and March 31st, 2023.

Participants

906 completed eConsults were submitted by 21 PCPs in correctional facilities.

Results

The top three specialties sent to were cardiology (46%, N = 417), dermatology (14%, N = 128), and endocrinology and metabolism (8%, N = 68). The median specialist response time was 0.9 days. The median time specialists spent responding to each case was 15 minutes. PCPs received advice on a new or additional course of action in 34% of eConsult cases. In-person specialist appointments were avoided in 81% of cases.

Conclusions

Ontario eConsult provides an ideal venue to improve access to multispecialty advice for people who are incarcerated. This service reduces the need for face-to-face specialist visits, decreases cost-of-care, and avoids unnecessary transportation outside of correctional facilities with potential security issues.