eConsult Model to Tackle Rural-Urban Health Deficit

A new eConsult model giving patients and GPs in western Queensland access to input from city-based specialists is set to launch next year. The model is a variation of that used by top US healthcare organisation, the Mayo Clinic and will provide GPs and rural patients with complex chronic diseases input from chronic disease management specialists without a face-to-face consultation.

The model is quite different to videoconferencing, replacing the telephone conversation with a written summary. It means patients don’t have to go to a face-to-face interview.

How the eConsult model works

Under the eConsult model, GPs who might be considering referring their patient for an outpatient visit in a distant city instead email a general physician with a number of targeted questions, to request specific advice. The general physician responds within 72 hours, and the patient then returns to the GP to talk through the advice.

Evidence from overseas has shown eConsults can cut waiting times, reduce hospital presentations, and reduce the need for long, expensive trips to seek hospital care in major cities.

Crucially, the model is asynchronous, reducing the effort required to get patient, GP and specialist on the same call.

eConsults in Queensland

Australian program leader Professor Claire Jackson, a member of the Primary Health Care Advisory Group and past RACGP President, said the program will cut through the “tyranny of distance to intervene early in the disease process and reduce avoidable hospital visits”.

“Currently, limited local availability of specialist access in western Queensland means patients travel long distances to access specialist services in regional centres or Brisbane, or rely on clinician–patient real-time video link,” she said.

The initiative comes following the roll out of another initiative, the ECHO Model, which relies on case conferences between GPs and other specialists and experts.

“ECHO has a big area of interest in [for example] ADHD management in Queensland, with a number of GPs very committed to it. But it is a different model,”she said. 

“Case conferences limit the number of GPs who are available repeatedly over time. It’s not really scalable. We’re looking at what can scale nationally.”


The eConsult program is a joint effort between Professor Jackson’s Centre for Health System Reform and Integration at the University of Queensland, Queensland Health, the Western Queensland Primary Health Network, the Mater Hospital in Brisbane and the Australian Digital Health Agency.

The model is one of three initiatives cited in Professor Jackson’s recent nomination for Research Australia’s Health Services Research Award.

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