{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T20:24:31Z","timestamp":1791404671102,"version":"4.3.3"},"reference-count":16,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Hum Factors"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Long COVID is an often debilitating condition affecting millions of people. Its diverse clinical presentations make effective diagnosis and management at the primary care level difficult, while specialist services for long COVID face extensive wait times. An electronic consultation (eConsult) program in Ontario developed a long COVID specialist group to allow primary care providers (PCPs) prompt access to specialist advice for patients with long COVID.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study aims to assess patterns of service use, response times, impact, and clinical content of eConsult cases submitted to an eConsult long COVID specialist group in Ontario.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This study is a mixed methods analysis of eConsults submitted by PCPs to the long COVID specialist group of 2 eConsult services (Champlain eConsult BASE and Ontario eConsult) between June 1, 2021, and July 31, 2022. Data sources included the use data collected automatically by the services, responses to a mandatory closeout survey, and the content of PCP questions and specialist responses (Champlain eConsult BASE service only). Clinical questions or responses were analyzed using 2 validated taxonomies. Descriptive statistics were used for survey responses and use data.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n A total of 40 PCPs submitted 47 eConsults through Champlain eConsult BASE and 197 PCPs submitted 228 cases through Ontario eConsult. The median specialist response time was 0.6 (IQR 0.19-2.36; mean 1.7, SD 2.29) days. The 5 most common symptoms of long COVID were fatigue (14\/47, 30%), dyspnea (7\/47, 15%), cough (6\/47, 13%), altered sense of smell (ie, anosmia and parosmia; 6\/47, 13%), and cognitive changes (6\/47, 13%). The five main question categories asked by PCPs were: (1) management of chronic symptoms of COVID-19, (2) need for additional work-up or follow-up testing, (3) community resources to support or manage patients with long COVID, (4) diagnostic clarification, and (5) guidance regarding COVID-19 vaccination.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n The long COVID groups provided rapid access to a multispecialty service that facilitated the avoidance of unnecessary face-to-face referrals. An assessment of eConsults highlighted 5 common question types, providing insight into potential gaps in knowledge among PCPs that could help guide medical education and policy.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/58582","type":"journal-article","created":{"date-parts":[[2025,2,28]],"date-time":"2025-02-28T12:15:57Z","timestamp":1740744957000},"page":"e58582-e58582","source":"Crossref","is-referenced-by-count":2,"title":["The Utilization of Electronic Consultations (eConsults) to Address Emerging Questions Related to Long COVID-19 in Ontario, Canada: Mixed Methods Analysis"],"prefix":"10.2196","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0653-0091","authenticated-orcid":false,"given":"Jatinderpreet","family":"Singh","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4558-9325","authenticated-orcid":false,"given":"Michael","family":"Quon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-8109-6696","authenticated-orcid":false,"given":"Danica","family":"Goulet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3407-5065","authenticated-orcid":false,"given":"Erin","family":"Keely","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0699-5494","authenticated-orcid":false,"given":"Clare","family":"Liddy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2025,2,28]]},"reference":[{"key":"R1","unstructured":"COVID-19 dashboard. World Health Organization. URL: https:\/\/covid19.who.int\/ [Accessed 20-02-2025]"},{"key":"R2","unstructured":"Coronavirus disease (COVID-19): post COVID-19 condition. World Health Organization. 2023. URL: https:\/\/www.who.int\/news-room\/questions-and-answers\/item\/coronavirus-disease-(covid-19)-post-covid-19-condition [Accessed 20-02-2025]"},{"key":"R3","unstructured":"Long-term symptoms in canadian adults who tested positive for COVID-19 or suspected an infection, january 2020 to august 2022. Statistics Canada. 2022. URL: https:\/\/www150.statcan.gc.ca\/n1\/daily-quotidien\/221017\/dq221017b-eng.htm [Accessed 20-02-2025]"},{"issue":"3","key":"R4","doi-asserted-by":"publisher","first-page":"220","DOI":"10.1370\/afm.2807","article-title":"Evaluation of an electronic consultation service for COVID-19 care","volume":"20","author":"Singh","journal-title":"Ann Fam Med"},{"issue":"3","key":"R5","doi-asserted-by":"publisher","first-page":"262","DOI":"10.1370\/afm.2812","article-title":"The provincial spread and scale of the Ontario eConsult service: evaluation of the first 2 years","volume":"20","author":"Liddy","journal-title":"Ann Fam Med"},{"issue":"6","key":"R6","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2015-010920","article-title":"Improving access to allied health professionals through the Champlain BASE","volume":"6","author":"Liddy","journal-title":"BMJ Open"},{"issue":"1","key":"R7","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1089\/tmj.2018.0012","article-title":"Specialist perspectives on Ontario provincial electronic consultation services","volume":"25","author":"Keely","journal-title":"Telemed e-Health"},{"issue":"9","key":"R8","doi-asserted-by":"publisher","first-page":"1039","DOI":"10.1089\/tmj.2020.0338","article-title":"Primary care providers\u2019 perspectives on the Ontario eConsult program","volume":"27","author":"Liddy","journal-title":"Telemed J E Health"},{"issue":"11","key":"R9","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.40332","article-title":"Complexity and challenges of the clinical diagnosis and management of long COVID","volume":"5","author":"O\u2019Hare","journal-title":"JAMA Netw Open"},{"issue":"1","key":"R10","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2021-050979","article-title":"Experiences of living with long COVID and of accessing healthcare services: a qualitative systematic review","volume":"12","author":"Macpherson","journal-title":"BMJ Open"},{"issue":"3","key":"R11","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1038\/s41579-022-00846-2","article-title":"Long COVID: major findings, mechanisms and recommendations","volume":"21","author":"Davis","journal-title":"Nat Rev Microbiol"},{"key":"R12","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2023.1149922","article-title":"Improved clinical outcomes in response to a 12-week blended digital and community-based long-COVID-19 rehabilitation programme","volume":"10","author":"Smith","journal-title":"Front Med (Lausanne)"},{"issue":"12","key":"R13","doi-asserted-by":"publisher","first-page":"1791","DOI":"10.1111\/sms.14240","article-title":"Rehabilitation for post\u2010COVID \u201019 condition through a supervised exercise intervention: a randomized controlled trial","volume":"32","author":"Jimeno\u2010Almaz\u00e1n","journal-title":"Scand Med Sci Sports"},{"issue":"6","key":"R14","doi-asserted-by":"publisher","first-page":"603","DOI":"10.1001\/jama.2020.12603","article-title":"Persistent symptoms in patients after acute COVID-19","volume":"324","author":"Carf\u00ec","journal-title":"JAMA"},{"issue":"10","key":"R15","doi-asserted-by":"publisher","first-page":"1614","DOI":"10.1016\/j.jaccas.2020.04.018","article-title":"Misdiagnosis in the COVID-19 Era: when zebras are everywhere, don\u2019t forget the horses","volume":"2","author":"Yousefzai","journal-title":"JACC Case Rep"},{"key":"R16","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2021.637375","article-title":"Diagnostic delay of pulmonary embolism in COVID-19 patients","volume":"8","author":"Melazzini","journal-title":"Front Med (Lausanne)"}],"container-title":["JMIR Human Factors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/humanfactors.jmir.org\/2025\/1\/e58582","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T17:50:35Z","timestamp":1782841835000},"score":1,"resource":{"primary":{"URL":"https:\/\/humanfactors.jmir.org\/2025\/1\/e58582"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,28]]},"references-count":16,"URL":"https:\/\/doi.org\/10.2196\/58582","relation":{},"ISSN":["2292-9495"],"issn-type":[{"value":"2292-9495","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,28]]},"article-number":"v12i3e58582"}}