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Demand for specialty care has risen rapidly in the United States in recent years, with referrals to specialists more than doubling. Because of this, patients’ access to specialists have suffered.
Along with the increasing referral rates, there is a decrease in communication and coordination between primary care providers (PCPs) and specialists, creating inefficiencies and the risk of quality gaps in care.
Over the past three years, the AAMC has worked with a growing collaborative of academic medical centers (AMCs) to implement an innovative model that improves the quality and efficiency at the interface of primary care and specialty care. Through Project CORE, AMCs implement tools known as eConsults and enhanced referrals, embedded in the electronic medical record system, that target improved provider workflows and alignment of incentives between providers.
Project CORE: Coordinating Optimal Referral Experiences―Implementing eConsults and Enhanced Referrals, aims to improve the quality of care and the patient experience while reducing the overall cost of care by enhancing communication and coordination between primary care and specialty physicians. Through the Project CORE model, developed and piloted at UCSF,
- Patients have improved access to care with fewer unnecessary tests and visits;
- Primary care physicians receive timely input and expertise from specialists clearly and succinctly documented in the electronic medical record (EMR); and
- Specialists receive clear clinical questions with necessary pre-referral evaluation completed, providing more efficient referrals.
To learn more about the model, please view the Project CORE Overview .
Expanding the Collaborative
The AAMC is committed to further scaling this innovation and improving the quality of ambulatory care for its members. In 2017, the CORE program will expand the collaborative to support academic medical centers in implementing the CORE model. To learn about program requirements and benefits and services, please download the Program Participation Overview . For more information, or to inquire about participating in the 2017 collaborative, please email firstname.lastname@example.org.
Below are key references that describe the current challenges in care coordination and communication at the primary care-specialty care interface, and the opportunities for innovations in electronic consults and referrals to improve quality of care delivery in this area.
- Review recent research on eConsults and eReferrals
- Advancing the Primary/Specialty Care Interface Through eConsults and Enhanced Referrals. Davis A, Gilchrist V, Grumbach K, James P, Kallenberg R, Shipman SA. Ann Fam Med. 2015 July;13(4):387-9.
- When to Repatriate? Clinicians' Perspectives on the Transfer of Patient Management from Specialty to Primary Care. Ackerman SL1, Gleason N, Monacelli J, Collado D, Wang M, Ho C, Catschegn-Pfab S, Gonzales R. J Gen Intern Med. 2014 Jun 17.
- eReferral -- A New Model for Integrated Care. Chen AH1, Murphy EJ, Yee HF Jr. N Engl J Med. 2013 Jun 27;368(26):2450-3.