Primary Care Provider RLT | ||
No | Item | Question |
1 | Clinical Question | What was your clinical question? |
2 | Learning | How did the special’s response to this eConsult impact your knowledge or understanding? |
3 | Improvement to the Specialist’s Response | How could this response have been improved? |
4 | Application to Patient Care | Will you use this eConsult information for your patient? |
5 | Anticipated Benefits | Do you expect any benefit(s) to the patient as a result of applying this eConsult information? |
6 | Sharing Patient Outcomes | If you and this patient are willing to share the patient outcomes with the specialist, please click here |
7 | Send Feedback to the Specialist | Are you willing to share a copy of this survey with the specialist? |
Specialist RLT | ||
No | Item | Question |
1 | Clinical Question | Was the clinical question clear? |
2 | Information to Facilitate Consultation | Did the PCP include sufficient and appropriate information to facilitate your consultation? |
3 | Resources Consulted | What resources did you use to answer the PCP’s question other than personal knowledge/experience? |
4 | Additional Information from PCP | Did you seek additional information from the referrer? |
5 | Learning & Application of Learning | Did you learn anything from this eConsult request? How are you planning to use this information in your practice? |
6 | Sharing Patient Outcomes | Would you like the PCP to share the patient outcomes with you? |