Expanding Electronic Consults to Providers
Community health center providers deliver culturally and linguistically aligned care, driven by a mission to serve the underserved. Their patients often come with high medical need shaped by their social and economic reality. When a primary care provider (PCP) encounters a patient with a challenge beyond his or her expertise, having access to the latest information and specialty expertise can make all the difference for a successful outcome.
One family practitioner at La Clínica, Dr. S., described the challenge, “…We try to patch together things from the knowledge that we already have, but for some of the things we find… it’s hard to know where we should follow it and whether we should be referring it (to a specialist), what’s the ideal way to manage this problem?”
Referring patients to specialists can take time, and delays can negatively affect health outcomes and costs. Delays result in worsening of untreated conditions, and discouraged patients may not appear to the delayed appointment. Transportation obstacles may also prevent the patient from going to an appointment beyond their neighborhood. When conditions worsen, costs for care go up. Often, with the right information, the referral may not even be necessary and the case treated on the spot.
“A really important part of a patient visit…is the provider having access to clarification for things they don’t understand. Once I started really using Rubicon I realized how many questions I had in a single day,” says Dr. S.
The e-consult solution, RubiconMD: In order to make the best decision about specialty referrals, providers need fast, accurate and current information that fits the community health center workflow. RubiconMD offers a secure, web-based platform and smartphone application for PCPs to submit specialty consultations prior to referring a patient for a specialty visit. PCPs use RubiconMD as a tool for informal discussion with specialists in order to improve specialty referrals. Providers can easily upload documents, labs, test, clinical notes, and images from the electronic health record to RubiconMD’s platform for quick and efficient consultation
Dr. S. points to the high quality of RubiconMD specialists and the benefits RubiconMD provides in preparing a patient for a specialty visit. By knowing what labs are needed prior to the specialty visit, “…it makes things more efficient. They may need only one visit with the specialist instead of two and that may save the system money in the long run. It improves patient experience…it’s a win for the patient.”
Improving Care while Saving Time and Money
Each PCP has unlimited access to specialty consults and use of the platform. RubiconMD offers consultations in more than 105 specialty types, including high-demand specialties such as dermatology, endocrinology and a variety of pediatric sub-specialties. The phone app makes uploading a photo for a dermatologist to evaluate very easy. Consulting with specialist from RubiconMD’s network prior to referring the patient to a local specialist reduces unnecessary referrals and allows providers to manage the member’s care in the familiar setting of the health center. The platform also allows PCPs to share cases and solutions with other users from their clinics, an added educational component for both patient and provider. Some behavioral health providers in CHCN-affiliated health centers also use RubiconMD.
“I would definitely give that tool to any provider, I would recommend it as a way of taking care of our patients and educating ourselves… we have a new provider coming on board and I’m definitely going to encourage her to use it,” says Dr. S.
CHCN initially piloted e-consults with two member health centers: Axis Community Health in Pleasanton and Livermore (Alameda County) and La Clínica sites in Concord, Oakley, and Pittsburg, (Contra Costa County). The average specialist response time is between 2.5 and 4 business hours on RubiconMD, a significant improvement from specialty appointments wait times of 2 weeks or more.
- Frequently Asked Questions
- CHCN staff published article in New England Journal of Medicine Catalyst
- Benefits of E-Consult published in Annals of Family Medicine article
- California Health Care Foundation Invests in RubiconMD
- Center for Care Innovations Spotlight on CHCN E-Consults