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Introduction: To support the expansion of a successful regional electronic consultation (eConsult) service, we hosted a full-day national eConsult Policy Think Tank, connecting health-services researchers, clinicians, patients and policymakers to discuss policy considerations related to eConsult. In this paper, we assess the discussion arising from the Think Tank to identify and understand the policy enablers and barriers to the national spread and scale of eConsult services across Canada.Methods: We conducted a constant comparative thematic analysis of stakeholder discussions captured during the Think Tank held in Ottawa, Canada, on 5 December 2016. Forty-seven participants attended and debated the following topic areas: (a) delivery of services and standards; (b) payment considerations; and (c) equitable access. The meeting was recorded, and verbatim transcripts were analysed using qualitative approaches.Results: We identified four themes affecting spread and scale of eConsult innovation from a policy perspective: (a) patient-centredness; (b) value; (c) regulation; and (d) considerations for spread and scale. Patient-centredness was viewed as a foundational principle upon which policy shifts should be guided. Active participation of patient partners transitioned the discussions and resulting recommendations from provider-centred to patient-centred thinking around the relevant policy issues, explicitly demonstrating the importance of patient involvement in healthcare policy decision making.Discussion: eConsult was viewed as a high-value, disruptive innovation with great potential to transform access to specialists in Canada. A patient-centred approach to policy change (and not just healthcare delivery) was identified as a novel yet critical enabler to the scale and spread of eConsult across Canada. [ABSTRACT FROM AUTHOR]

In 2003, a large German public health insurance fund launched the GesundheitsCard Europa (GCE) or Health Card Europe. Staff in the 14 participating hospitals along the Dutch and Belgium coast could use a multilingual Website to confirm immediately the insurance status of patients presenting a GCE. Reimbursement was speeded up by using the Web portal in co-operation with the insurance partners. A thorough analysis of the economic performance of the GCE service, accounting for all stakeholders was conducted. The number of paper forms issued by the insurer for travel to The Netherlands fell from about 200,000 annually to about 40,000 per year. In 2004, three years after the project started, cumulative benefits exceeded cumulative costs. The investment was about €500,000 and the annual running costs were about €150,000. In comparison, the overall annual net benefits were about €450,000. The GCE is a proprietary, but generalisable solution to a specific European problem: low acceptance of health insurance certificates. [ABSTRACT FROM AUTHOR]

The Universitas 21 (U21) organization funded a one-year project to examine global e-health. An e-health steering committee surveyed the opinions of e-health researchers at U21 member schools and conducted a literature review. Information about key themes was analysed and the findings were summarized. The steering committee recommended an eight-step strategy to establish a sustainable endeavour in global e-health. This included implementing a dissemination strategy within the U21 organization to engage a progressively larger community of faculty members and others, and translating e-health knowledge into global practice in those areas in which the U21 has special expertise. While the recommendations in the discussion paper are specific to the U21 organization, the e-health steering committee believes they can be generalized and applied to any globally minded educational or research institutions seeking to contribute to e-health. [ABSTRACT FROM AUTHOR]