In this 3-part series, we will discuss how implementing the AristaMD platform can support the transition to value-based care payment models.
- Part 1: How is the VBC payment model changing?
- Part 2: What challenges are driven by the value-based care transition?
- Part 3: eConsults for successful value-based care
Health plan administrators, ACO leadership teams, physicians and practice staff often comment that the pandemic highlighted existing challenges. Staff turnover, increased patient care delivery demands and changing reimbursement models put pressure on stretched resources at every healthcare system level. As a result, providing appropriate care requires all of us to rethink specialty referral workflows.
The healthcare staffing shortages impact patients, practices and the entire healthcare delivery system. Nearly 1.7 million healthcare workers have quit this year. The remaining 76% of healthcare workers say they are burned out and exhausted.
AristaMD offers a solution to gaps in the specialty workflow. Our platform combines eConsults with referral tracking and management to:
- Reduce the impact of staff turnover and provider shortages.
- Optimize the selection and direction of in-network referrals.
- Improve specialty care coordination and outcomes.
- Manage wait times for specialty care.
Reduce the Impact of Staff Turnover and Provider Shortages
Using a platform that offers both eConsults and specialty referral management enhances care consistency and avoids gaps in patient care when staff leave. By deploying a unified approach that allows staff to track both eConsults and face-to-face referrals in a single location, healthcare providers ensure patients don’t fall through the cracks. In addition, the provider team, whether consisting of new employees or tenured team members, can easily identify the optimal specialty care setting for a patient and the status of that patient in the eConsult or referral process.
eConsults replace more than 70% of face-to-face specialty care visits. While there are other eConsult vendors out there, AristaMD is one of the only vendors deploying a documented eConsult (vs. curbside consultation) where evidence-based care guidance and responding specialist biographies are shared with providers.
For primary care providers, eConsults lower or eliminate risks associated with transferring care to a specialist, which includes:
- Long wait times – in some markets, patients are experiencing appointment wait times of over 100 days for common specialties like cardiology, rheumatology, endocrinology, and dermatology. In one state, we recently heard that wait times for several vital specialties were up to 12 months.
- Care delays or inappropriate ED use – More than half of patients referred to specialists will not attend the appointment. Then, when their symptoms escalate, they will seek care in the ED.
Reducing the burden of coordinating specialist referrals can be a huge time saver for the office staff.
Benefits of eConsults to Value-Based Care Providers
Improve Specialty Care Coordination and Outcomes
eConsults to Improve Patient Compliance
Primary care providers request eConsults to save time and money for the practice and the patient. However, they also request an eConsult when a patient is unable or unlikely to visit the specialist. There are lots of reasons why patients do not follow through with a specialty care referral:
- No transportation
- Lack of childcare
- Inability to take time off work
- No funds to pay an additional copay
eConsults mitigate these social determinants of health that reduce patient outcomes by providing specialty care advice at the primary care office. In addition, eConsult specialists are trained to offer follow-up actions if the initial recommendation has limited success. If the specialist recommends a specific test, the eConsult will include what results to expect and treatment options based on the results. The specialist may sometimes recommend an eConsult in an additional specialty. These situations allow the PCP to coordinate care across multiple specialties efficiently. For example, a diabetic patient requires input from an endocrinologist and a wound care specialist.
This step-based process for diagnosing and treating patients improves care coordination because the PCP receives and records all the diagnostic and treatment recommendations. Outcomes are improved when patients that are unable to coordinate a face-to-face visit receive needed specialty care.
Manage Wait Times for Specialty Care
eConsults help your practice and the entire health system manage wait times for specialty care. Let’s review a few of the ways that wait times are minimized:
- eConsults replace more than 70% of face-to-face specialty visits.
- eConsults support obtaining appropriate diagnostics before a face-to-face specialty visit.
- More than 40% of eConsults result in a new diagnosis, which means that the PCP can route the patient to the appropriate specialist – reducing unnecessary specialty care visits that limit the number of available appointments.
eConsults support value-based care by lowering costs and increasing efficiency.