ISQUA18-1492Better Communication, Better Quality Person-Centred Care: Supporting Primary Care in the Community with eConsult
Bibliographic record
Abstract
Objectives: Poor access to specialist care is a serious issue in Canada. A 2016 survey by the Commonwealth Fund ranked it last among 11 countries surveyed on wait times for specialist treatment.(1) To address this issue, we launched the Champlain BASE™ (Building Access to Specialists through eConsultation) eConsult service, a secure online application that allows primary care providers (PCP) and specialists to communicate electronically regarding a patient’s care. PCPs log into the service using a web browser, enter their question, attach any supplementary files (e.g. photographs, test results), and select a specialty group such as dermatology, endocrinology, etc. The case is assigned to an available specialist, who responds within one week with advice for treatment, in-person referral, or further investigation. We evaluated the service’s impact on supporting PCPs in the community by providing timely access to high quality specialist advice, enhancing care around the needs of the patient rather than availability of specialists.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.019 | 0.031 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.003 | 0.002 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.005 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.214 | 0.017 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".