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Project CORE: Coordinating Optimal Referral Experiences

Demand for ambulatory subspecialty services has grown at rates that have overwhelmed many academic medical centers’ (AMCs) capacity, impairing access and creating unacceptably long wait times for patients. This drives down patient and provider satisfaction, and leads to lost revenue, reduced quality of care, and lost leverage in payer negotiations.

A growing number of AMCs have committed to implementing an innovation model that improves efficiency and effectiveness at the interface between primary care and specialty care, thereby improving quality of care and access, each in a patient-centered way. Based on a model initially developed and piloted at the University of California, San Francisco, the AAMC launched this innovation in 2014, now called Project CORE: Coordinating Optimal Referral Experiences. Through Project CORE, the AAMC is committed to helping AMCs improve the referral experience for both clinicians and patients. Download and review our CORE model overview. 

Already, the AAMC has partnered with 27 AMCs to successfully implement eConsults and enhanced referrals, tools built into the electronic medical record system through the CORE model. Through the CORE model, many AMCs have achieved impactful cost and operational efficiencies together with improved patient experiences -- Project CORE is a true collaboration between AAMC experts and AMC staff. Learn what to expect with Project CORE through our program benefits and services .

Currently, the AAMC is seeking to identify institutions interested in joining the next Project CORE collaborative. For information on how to join the CORE community, email

Learn more by watching our introductory video and reading "eConsults Reduce Need for Specialty Referrals."

Check out our latest CORE infographic featuring program impact data  from our first cohort of AMCs!

Questions? Please contact

The CORE community is achieving positive results and continues to grow. By 2018, the CORE community has increased from 5 to 27 Academic Medical Center (AMC) participants. To date, Project CORE participants:

  • Implemented eConsults and enhanced referrals in nearly all medical and surgical specialties, as well as in pediatric specialties and a growing number of ancillary specialties
  • Completed over 23,000 eConsults as of May 2018, with more than 1,000 additional eConsults being placed every month across the first two cohorts, resulting in thousands of avoided unnecessary referrals and inefficient curbside consults
  • Achieved high levels of patient, primary care provider, and specialist satisfaction with eConsults
  • Achieved high rates of primary care provider use of the model, with more than 80% of primary care providers using eConsults on an ongoing basis at sites where the model is mature
  • Begun efforts to further scale the model and ensure sustainability, including engaging with payers and extending to external primary care providers and systems

Site Spotlights:
We’re proud of the results achieved by academic medical centers (AMCs) within the CORE community. Several AMCs have agreed to share their story and you can find more in the news.

CORE in the News

CORE Participants

  • Dartmouth-Hitchcock (cohort 1 & pediatrics)
  • East Carolina University Physicians (cohort 2)
  • Greenville Health System (cohort 3)
  • Medical College of Wisconsin (cohort 3 & pediatrics)
  • MetroHealth System (cohort 3)
  • Ohio State University (cohort 2)
  • Oregon Health & Science University (cohort 3 & pediatrics)
  • Penn State Health (cohort 3)
  • University of California, San Diego Medical Center (cohort 1)
  • University of California, San Francisco (pediatrics)
  • University of Colorado Health (cohort 3 & pediatrics)
  • University of Iowa Hospitals and Clinics (cohort 1)
  • University of Michigan (cohort 2 & pediatrics)
  • University of Utah Health (cohort 3)
  • University of Virginia Medical Center (cohort 1 & pediatrics)
  • University of Washington Medicine (cohort 2)
  • University of Wisconsin (UW) Health (cohort 1 & pediatrics)
  • Vidant Health (cohort 2)
  • Wake Forest Baptist Health (cohort 2 & pediatrics)
  • Yale University - Yale Medicine (cohort 3)

Questions? Please email