NYC Health + Hospitals has expanded its eConsult system—a tool that eases communication between primary care providers and specialists—to 81 primary clinics, the health system announced.
NYC Health + Hospitals, the country’s largest municipal health system, first piloted eConsult in eight clinics beginning in August 2016 and has scaled up the program since. Seven hospitals in the system currently field referrals, up from two at the pilot’s launch.
Nearly 51,000 referrals have been made through the tool since the pilot began. In January, the platform was available in 29 clinics that made about 2,300 referrals per month. As of September, the program has reached 81 clinics making 4,100 referrals each month.
Mitchell Katz, M.D., CEO of NYC Health + Hospitals, said in a statement that lessons learned during his prior stint leading the Los Angeles County Health Agency helped chart a course for eConsult in New York City. Katz joined the New York health system last year.
“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,” Katz said.
The eConsult platform is designed to streamline the referral process and facilitate more direct communication between specialty and primary care providers. If a patient visits his or her PCP with a condition that may need a specialist’s input, the primary care team can send a message to the specialist through eConsult and receive details on next steps and how to set up the referral in short order.
In some cases, the specialist will offer guidance for treatment by the PCP, including suggesting tests and screenings or suggesting prescriptions. If a visit to the specialty care provider is needed, the response will set up that visit.
The early period of the pilot showed promising results, according to NYC Health + Hospitals. Between December 2016 and July 2017, median wait times for specialty care decreased from 50 days to 28 days. For patients who needed a visit urgently, median wait times decreased from 30 days to 16 days in that same window.
Of the 50,826 referrals made through the platform so far, 7,735 patients were treated in the primary clinic instead of visiting a specialist. An additional 35,589 were evaluated and scheduled a low-priority visit to the specialist.
Evaluating referrals more efficiently cuts down on the workload for specialists and improves care for the patients seeking those visits, said Hannah Byrnes-Enoch, director of specialty care transformation in the Office of Population Health.
“By having a significant number of patients triaged in the primary care setting and by reducing the number of inefficient visits to specialists, we have freed up valuable appointment time with our specialists, which makes a huge difference for patients,” Byrnes-Enoch said.