Table 1.
A description of the five dimensions of care outlined by the RE-AIM framework
| RE-AIM dimension | Definition | Questions specific to eConsult evaluation |
|---|---|---|
| Reach into the target population | The absolute number, proportion and representativeness of individuals who are willing to participate in a given initiative, intervention or program. | What was the absolute number and proportion of patients reached and served via eConsult service? Which patients were reached in terms of the breadth of specialties accessed through the eConsult service? |
| Effectiveness or efficacy | The impact of an intervention on important outcomes, including potential negative effects, quality of life and economic outcomes. | What was the impact of eConsult on the key areas to care quality: population health, patient experience, provider experience and cost? |
| Adoption by target settings, institutions and staff | The absolute number, proportion, and representativeness of settings and intervention agents (people who deliver the program) who are willing to initiate a program. | What was the uptake of the eConsult service (absolute number, regional proportion, monthly growth over time) among the PCP population in MH LHIN? What was the uptake/participation among the specialists/specialty groups from the MH LHIN? |
| Implementation consistency, costs and adaptions made during delivery | The consistency and fidelity to the program protocol, the costs and adaptations made during delivery. | What was the fidelity to the essential steps (Liddy et al. 2013b) (including establishing partnerships, addressing privacy issues, physician engagement and payment) previously described as necessary for replication of eConsult platform in other health regions? |
| Maintenance of intervention effects in individuals and settings over time | The extent to which a program or policy becomes institutionalized or part of the routine organizational practices and policies. | What is the ongoing usage of eConsult? What were the reinforcing factors required to maintain the eConsult service? |
MH LHIN = Mississauga Halton Local Health Integration Network; PCP = primary care provider.