VCC Dr. QA Manager Dr. Kevin Ronan speaks to the efficacy of using an eConsult solution within the FQHC and PCMH model
As a federally qualified health center, Vista Community Clinic is a safety net for its neighborhood, managing an uninsured or underinsured patient population – in this case, 58 percent Medicaid, 2 percent Medicare and 32 percent uninsured.
Access to specialty care is tough for these patients for several reasons, including transportation, child care, challenges with missing work and prolonged waiting lists for appointments.
For our clinicians, it is hard to provide comprehensive primary care to our patients with complex or comorbid conditions in a 15- to 20-minute appointment,” said Dr. Kevin Ronan, manager of quality assurance and a pediatrician at Vista Community Clinic. “And sometimes, what we needed was more of a curbside consult for recommendations on tests to order, a way forward or a sanity check on our current treatment plan, while awaiting a face-to-face appointment.
The clinic decided on a telehealth system from vendor AristaMD called eConsult Platform, which is designed to provide timely access to specialists for guiding patient care.
“This greatly increases access to quality specialty care for our patients, allowing primary care physicians to more efficiently manage patients,” Ronan said. “The solution is seamlessly integrated into our physician referral workflows, so clinicians do not have to spend any additional time creating a separate e-consult.”
The platform, the proposal said, would significantly reduce the need for face-to-face visits, improve coordination of care, and enhance both patient and provider satisfaction.
There are many vendors on the market today offering telemedicine technology, including American Well, Avizia, GlobalMed, MDLive, Novotalk, SnapMD, Teladoc, TeleHealth Services, Tellus and Tyto Care.
MEETING THE CHALLENGE
With the new telemedicine technology, the clinic’s clinicians are able to leverage hundreds of AristaMD’s board-certified specialists for care planning advice and recommendations, usually within 24 hours and fully documented within the clinic’s NextGen electronic health record.
“The platform is integrated into our existing referral workflow, interacting with Valer referral management and NextGen,” Ronan explained. “Our providers enter referral orders, and those referrals appropriate for an e-consult are converted into e-consult requests by AristaMD. Providers then receive a task via NextGen to review the specialist response and correspond with any follow-up questions before completing.”
Access to specialty guidance enables the primary care physicians to manage more complex patients, improving outcomes and reducing excess healthcare spending, he added.
“In a resource-scarce environment, we often co-manage patients in consultation with our AristaMD colleagues, until or unless a local specialist can be accessed,” he explained. “Care teams receive answers to questions in a timely fashion, frequently obviating the need for a face-to-face visit, which saves our patients time and expense. Photos to dermatologists and EKGs to cardiologists provide a reassuring oversight of patient care.”