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eConsult and advice

Not every dermatology question needs a face to face consultation. Ontario's eConsult service gives family physicians and nurse practitioners written specialist advice within days, and many questions can be answered from a good history and a clear image. This page describes the provincial service, how DermCare handles image and history referrals, and when a telephone call to the clinic is the right route.

Physician reviewing a clinical image on screen

Ontario eConsult

The Ontario eConsult Service is a provincial programme, accessed through OTNhub, that allows a primary care provider to submit a clinical question to a specialist and receive a written response, typically within a few days. Questions can include images and relevant results. The specialist may answer the question directly, ask for more information, or recommend a face to face referral. The service is funded provincially and there is no cost to the patient.

Dermatology is well suited to eConsult, because many skin questions can be resolved from history and images: whether a lesion needs to be seen, what to try next for a rash that has not responded to first line treatment, or how to monitor a patient on a medication you have started. Family physicians and nurse practitioners register for OTNhub through Ontario Health, and the eConsult service is available across the province through regional and provincial specialist groups.

Whether DermCare's dermatologists answer eConsults through the provincial service, and under which specialty group, is being confirmed and will be stated here once known. In the meantime, eConsult remains available to you through any dermatologist group on the platform, and a face to face referral to DermCare can follow if the eConsult response recommends one.

Image and history referrals to DermCare

DermCare welcomes referrals that arrive with a clear image and a structured history. Even where a face to face visit is needed, an image lets the triaging dermatologist:

  • Set the triage priority with confidence, rather than from the written description alone
  • Book the right length of appointment and, where relevant, allow time for a biopsy at the first visit
  • Identify cases suited to phototherapy assessment or a particular clinic
  • Return advice to the referring office where the picture is clear and a visit may not be needed

Guidance on taking useful images is on the how to refer page. Please label each image with the patient's name, the site and the date, and fax images as full page prints behind the referral.

Advice is not a substitute for assessment

Written or telephone advice from a dermatologist who has not examined the patient is given on the information provided and is intended to support the referring clinician's own judgement. A pigmented lesion that concerns you should be referred for examination, not for advice, and should be marked urgent where the criteria on the urgent triage page apply.

Telephone advice

Referring physicians with a question about whether a case is suitable for referral, how it is likely to be triaged, or what to include, can call 905 625 5600 and ask for the referral desk. Where a clinical question needs a dermatologist, the desk will take a message and a physician will return the call between patients. Please have the patient's details to hand in case a referral is the outcome.

Telephone advice is not recorded in the patient's chart at DermCare unless a referral follows. Document the advice in your own record.

Patients already under our care

For a patient we have already seen, questions about the treatment plan, a side effect, or a change in the condition should come to the clinic directly rather than through a new referral or an eConsult. Call 905 625 5600 with the patient's name and date of birth. The dermatologist who saw the patient will respond, and the exchange is documented in the chart and, where it changes the plan, reported back to you.

Frequently asked questions

Does an eConsult replace a referral?
Sometimes. If the specialist's written answer resolves your question, no referral is needed. If the answer recommends a face to face assessment, send a referral and attach the eConsult response, which will help us triage.
Can I email an image to the clinic?
No. Email is not a secure channel for personal health information and the clinic does not accept clinical images or referrals by email. Fax the image as a full page print behind the referral. A secure electronic referral pathway is being confirmed.
Can patients use eConsult?
No. eConsult is a provider to provider service. Patients who have a question about a skin condition should see their family physician or nurse practitioner, who can submit an eConsult or send a referral.

An image with the referral

One image in daylight, with a coin for scale, faxed as a full page behind the form, is the single most useful thing you can add.

Image guidance