Measuring Practice Success and Patient Care:
eConsults Practice Performance & Cost Savings
Eric Urquiza, Sr. Vice President of Operations & Client Experience at AristaMD
eConsults deliver practice performance improvements and cost savings by:
- Replacing referrals
- Reducing unnecessary testing
- Limiting emergency visits
- Avoiding hospital readmissions
- Offering medication management
An eConsult that avoids a specialty referral results in the following benefits to practice performance:
- Three avoided specialty visits, the average number of appointments needed to diagnose and treat a patient.
- Each specialty visit costs approximately $300. The avoided visit savings to an at-risk practice is $900.
- Approximately 20% of patients have non-clinically indicated duplicate testing, which can be avoided using eConsults. Averaged per patient, unnecessary tests and lab work cost about $85.
- Accounting for the cost of the eConsult, the total savings is $885.
This example reflects the cost savings for a typical patient. What if your patient is at risk of visiting the ED, was recently discharged from the hospital, or takes multiple prescriptions?
There are more than 139 million emergency room visits each year. The Agency for Healthcare Research and Quality estimates that 13-27% of these visits could be managed outside the ED. Using a conservative 13%, 18 million ED visits could be avoided annually. Across the average patient panel, 137 ED visits could be managed in the primary care setting. A savings of $157,000. This is the single biggest area of potential cost savings for a primary care practice, followed by hospital readmissions.
A single hospital readmission costs about $15,000. 14% of patients are readmitted to the hospital within 30 days, and 27% of those readmissions are avoidable. This translates to about 7 patient readmissions within the average PCP patient panel. That’s $105,000 annually.
If you have a higher percentage of elderly patients or manage a high number of chronic conditions or comorbidities — this number could be much higher.
More than 56% of all patients will experience a drug-related error. Errors related to diagnosis were the most common reason. Not all errors will result in an Adverse Drug Event, but a surprising number occur yearly. The result is more than 1.3 million emergency visits and 350,000 hospitalizations. The cost of an ADE averages $9,900. Patients recently discharged from the ED or inpatient care are more likely to experience an ADE.
- Only 10% of elderly patients will be discharged on the same medication they were admitted to the hospital.
- 60% of patients will have three or more medicines changed during a hospital stay
- 28–40% of medications are stopped within the hospital
- 45% of medicines prescribed at discharge are new
Consulting a PharmD for a medication review via eConsult following a hospital discharge could save your practice a tremendous amount of money. The typical patient panel will experience four annual ADEs, costing your practice $9,900.
Evaluate Practice Performance Metrics for eConsult Programs
Practice performance metrics are in focus whenever a new tool is introduced to improve patient care. In this series, we’ll focus on practice success and patient care when adopting or maintaining an eConsult program. Many of these strategies apply to increasing the adoption of any new technology or program.
- Primary care providers lack the tools and time to help patients navigate care. The average PCP sees between 10-20 patients per day. Patient care is their goal. Adding new technology adds to their workload.
- At the same time, not getting specialist advice for the patient is creating additional work for PCPs. More than 40% of referrals never get scheduled. That means more work for the PCP as patients boomerang back to the primary care setting with the same untreated condition.
- 25% of our healthcare costs are for unnecessary tests and treatments.
How do eConsults solve these challenges? eConsults are proven to provide specialty healthcare cost savings for patients, providers and payers. eConsults also support value-based care in tangible and practical ways. They create a path to faster diagnosis and treatment, improve or eliminate wait times for specialists’ visits, increase access to sub-specialties, and minimize worsened health outcomes resulting from delayed patient care. At-risk practices see tremendous cost savings by eliminating unnecessary specialty visits, reducing ED use and preventing hospital admissions and readmission.
But once you have an eConsult program in place, how do you measure success and drive additional value for your practice?
Eric Urquiza
Sr. Vice President of Operations & Client Experience at AristaMD
Eric has 20 years of experience driving transformational healthcare IT programs, advancing patient care, improving access and outcomes for patients through technological solutions. He has been successful in leading many strategic client relationships and increasing provider adoption of telehealth solutions, ultimately leading to strong efficacy for underserved populations throughout the country. Eric holds a Master of Business Administration from the University of Redlands.