Article Text

Original research
Electronic consultation in correctional facilities worldwide: a scoping review
  1. Claire Sethuram1,2,
  2. Mary Helmer-Smith1,2,
  3. Sathya Karunananthan1,2,3,
  4. Erin Keely4,5,6,
  5. Jatinderpreet Singh2,
  6. Clare Liddy1,2,4
  1. 1C.T. Lamont Primary Health Care Research Centre, Bruyere Research Institute, Ottawa, Ontario, Canada
  2. 2Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada
  3. 3Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
  4. 4Ontario eConsult Centre of Excellence, The Ottawa Hospital, Ottawa, Ontario, Canada
  5. 5Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
  6. 6Division of Endocrinology/Metabolism, The Ottawa Hospital, Ottawa, Ontario, Canada
  1. Correspondence to Dr Clare Liddy; cliddy{at}


Objective To provide an overview of the use of and evidence for eConsult in correctional facilities worldwide.

Design Scoping review.

Data sources Three academic databases (MEDLINE, Embase and CINAHL) were searched to identify papers published between 1990 and 2020 that presented data on eConsult use in correctional facilities. The grey literature was also searched for any resources that discussed eConsult use in correctional facilities. Articles and resources were excluded if they discussed synchronous, patient-to-provider or unsecure communication. The reference lists of included articles were also hand searched.

Results Of the 226 records retrieved from the academic literature search and 595 from the grey literature search, 22 were included in the review. Most study populations included adult male offenders in a variety of correctional environments. These resources identified 13 unique eConsult services in six countries. Six of these services involved multiple medical specialties, while the remaining services were single specialty. The available evidence was organised into five identified themes: feasibility, cost-effectiveness, access to care, provider satisfaction and clinical impact.

Conclusions This study identified evidence that the use of eConsult in correctional facilities is beneficial and avoids unnecessary transportation of offenders outside of the facilities. It is feasible, cost-effective, increases access to care, has an impact on clinical care and has high provider satisfaction. Some gaps in the literature remain, and we suggest further research on patient satisfaction, enablers and barriers to implementation, and women, youth and transgender populations in this setting to inform service providers and stakeholders. Despite some gaps, eConsult is evidently an important tool to provide timely, high-quality care to offenders.

  • Quality in health care
  • Telemedicine

Data availability statement

Data are available upon reasonable request. All data relevant to the study are included in the article or uploaded as supplementary information. Questions about data, its collection and the analysis can be directed to the corresponding author, Dr Clare Liddy, at

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

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Data availability statement

Data are available upon reasonable request. All data relevant to the study are included in the article or uploaded as supplementary information. Questions about data, its collection and the analysis can be directed to the corresponding author, Dr Clare Liddy, at

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  • Twitter @ClaireSethuram

  • Contributors CS, MH-S, SK, EK and CL conceived of and designed the study. CS, MH-S and SK conducted data collection, analysis and reporting. All authors contributed to the analysis and interpretation of data. CS and MH-S drafted and revised the manuscript. SK, EK, JS and CL provided feedback and critical revisions for important intellectual content. All authors approved the final draft of the manuscript. CL is the guarantor and accepts full responsibility for the overall content.

  • Funding Funding for this study was provided by the Canadian Institutes of Health Research and the Ontario Ministry of Health and Long-Term Care.

  • Disclaimer The funders had no role in study design, data collection/analysis/interpretation or preparation of the manuscript.

  • Map disclaimer The inclusion of any map (including the depiction of any boundaries therein), or of any geographical or locational reference, does not imply the expression of any opinion whatsoever on the part of BMJ concerning the legal status of any country, territory, jurisdiction or area or of its authorities. Any such expression remains solely that of the relevant source and is not endorsed by BMJ. Maps are provided without any warranty of any kind, either express or implied.

  • Competing interests CL and EK are co-executive directors of the Ontario eConsult Centre of Excellence, funded by the Ontario Ministry of Health. They cofounded the Champlain BASE (Building Access to Specialists through eConsultation) eConsult service but do not retain any proprietary rights. EK answers eConsults through the service, less than one per month.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.