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eConsult proves valuable tool for NYC Health+Hospitals in cutting wait times, speeding referrals

For patients referred for an in-person specialty care visit, the median wait time decreased from 50 days before eConsult to 28 days.

Beth Jones Sanborn, Managing Editor

NYC Health + Hospitals in expanding the use of its eConsult system, which is a web-based tool that enables better communication between primary care providers and specialists. Because of the expansion, 81 specialty clinics are now using the tool, a significant increase from the eight specialty clinics that were onboard in the early stages of the eConsult pilot. NYC H+H said it expects the number of participating clinics to keep growing.

WHY IT MATTERS

The eConsult tool allows primary care providers and specialists to communicate more effectively and co-manage patients when appropriate, as well as allowing them to connect patients to specialty care.

The system is integrated through NYC Health + Hospitals' electronic health record systems, which helps with documentation.

THE TREND

The eConsult system pilot began in August 2018 with two hospitals. Now, each month more than 4,100 referrals are being reviewed at NYC Health + Hospitals-Bellevue, Coney Island, Harlem, Kings County, Jacobi, Lincoln, and Woodhull.

September 2018 marked a milestone of 52,000 referrals reviewed and triaged thus far.

WHAT ELSE YOU NEED TO KNOW

The eConsult system helps streamline the referral process by allowing for rapid messaging and responses between providers when a primary care provider's patient has a health concern that would typically be treated by a specialist. The communication around next steps and timely referral scheduling are therefore enhanced. 

Sometimes the communication is simply guidance that will allow the PCP to better treat the patient. Other times, when a specialist visit is necessary, the specialty clinic contacts the patient directly to schedule an appointment. Historically, the first visit with a specialist is brief and often includes directions for the patient to undergo testing; eConsult eliminates those visits allowing time for the most meaningful and effective facetime between patient and provider.

NYC H+H said eConsult has helped to cut wait times for specialty care, showing that for patients referred for an in-person specialty care visit, the median wait time decreased from 50 days before eConsult to 28 days in June 2017. The median wait time for a visit over the same time period decreased from 30 days to 16 days for high-urgency specialty visits.

ON THE RECORD

"When I was in Los Angeles, we saw how successful an eConsult program can be in supplementing and strengthening primary care, and implementation here in the largest public health system in the country is recording similar success," said Dr. Mitchell Katz, president and chief executive officer of NYC Health + Hospitals. "We are pleased to expand our eConsult system to continue to improve access for our patients."

The 4,100 referrals per month in 81 specialty clinics as of September is up from 2,300 per month in 29 specialty clinics as of January, when Dr. Katz started.

"Specialists like oncologists, orthopedic surgeons, and ophthalmologists often play a critical role in diagnosing and managing our patients' illnesses," said Dr. Dave Chokshi, vice president and chief population health officer at NYC Health + Hospitals. "eConsult helps facilitate more rapid access to specialist expertise, which is a priority as we continuously work to improve patient care."

Twitter: @BethJSanborn
Email the writer: beth.sanborn@himssmedia.com

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