Dr. Anne Fuhlbrigge, Senior Associate Dean for Clinical Affairs
Dr. Duane Pearson, PMCC Medical Director
Dr. Linda Oberst-Walsh, PCP Adult Lead
Dr. John "Fred" Thomas, PMCC Executive Director
Dr. David Keller, PCP Child Health Lead
In early 2018, we implemented an electronic consult workflow to allow for PCPs to send non-urgent medical questions to over 26 specialties on behalf of a patient’s medical concern, with the expectation that the specialist respond within 3 business day to the PCP. This workflow has improved access to timely specialty care and has tremendous benefit to our patients. Over 10,000 eConsults have been placed in 3 years, resulting in over 7,500 avoided in-person visits, which has saved patients co-pays, time off work, and unnecessary specialty visits. This has also resulted in more complex patients being seen for in-person visits. Patients have saved over $10,000 in gas from avoided visits. For Medicaid patients, eConsults were associated with a 9.35% reduction in per member per month total cost of care over the subsequent three months. Our workflow has been expanded to community based providers, resulting in more patients in Colorado, both rural and urban, receiving improved access to specialty care.
Over the past decade, the use of subspecialty medical services has risen rapidly in the United States, with referrals to specialists more than doubling. Along with increasing referral rates, the quality of communication and coordination between primary care providers (PCPs) and specialists has decreased over time. Patients are faced with poor access to specialists, high costs, and fragmented care. eConsults help to improve the quality of care and the patient experience while reducing the overall cost by enhancing communication and coordination between PCPs and specialty physicians.
Our eConsult program was launched in early 2018. Each quarter from 2018 to 2020 new specialties went live with the eConsult workflow. Over 2 years, we launched 26 specialties answering eConsults. In 2019, we expanded eConsults to select community providers and continue to grow our service to community providers through 2021. This service has received lots of local and national attention for having positive outcomes and satisfaction for both patients and providers.