L.A. Care's eConsult Program Drives Health Care Coordination in Los Angeles County

LOS ANGELESL.A. Care Health Plan, the nation’s largest public health plan, is proud to announce that only six months since its launch, its safety net eConsult program has surpassed its target number of clinical sites, thus decreasing the number of inappropriate and unnecessary specialty referrals at those locations. 

eConsult is a web-based platform that allows for primary care provider-to-specialist conversations aimed at speeding access to specialty care and better care coordination. The Safety Net eConsult Program is an initiative of L.A. Care reflecting its ongoing commitment to advancing health and health care using the latest in care coordination and communication technologies.

The Safety Net, the system that safeguards and provides care to the poor and uninsured,  in Los Angeles County has long been overwhelmed with the volume of patients needing access to specialty care. L.A. Care is committed to promoting efforts to increase access to quality health care for low-income and vulnerable residents. Through innovative partnerships L.A. Care developed the Safety Net eConsult Program, a straightforward approach to overhaul the “healthcare challenge” faced in Los Angeles County using telehealth and care coordination solutions to address the growing need for access to information and access to care.

“L.A. Care’s Safety Net eConsult Program is an exemplary model of how leveraging telehealth technologies can improve health care efficiency, health care access and quality of care,” says Howard A. Kahn, L.A. Care CEO. “We are thrilled to spearhead these efforts with our partners and have committed nearly $2 million toward the increased adoption of this program.”

The program is the largest scale implementation of primary care provider-to-specialist e-consultations anywhere in the nation. This effort to provide more efficient care coordination for low-income and vulnerable populations throughout Los Angeles County is a result of the collaboration between the Los Angeles County Department of Health Services (DHS), the Community Clinic Association of Los Angeles County (CCALAC) and Health Care LA Independent Physicians Association, with funding and project management provided by L.A. Care Health Plan, the lead agency for the program.

“There is a tremendous demand for specialty care within the safety-net system across the country. L.A. Care, the clinics and the Los Angeles County Department of Health Services have formed partnerships with stakeholders across the safety-net health system in Los Angeles County to address barriers and make the system more efficient and reduce wait times. Work is being done to improve access and pre-visit work-up to the specialty care and eConsult is being used to support our work in this area,” say Dr. Alexander Li, CEO of Ambulatory Care at the Department of Health Services. “So far, we have seen fantastic results with improved provider and specialists’ satisfaction, improved access for face-to face appointments with specialists after an eConsult and improved pre-visit work-up.”

More than 3,600 eConsults—electronic consultations—have been initiated across nine specialty care areas and used in 63 clinical sites and seven referral processing units. The eConsult Program has already reduced wait times for appointments and in many cases addressed the needs of the patient in the primary care setting, reducing the need for patients to see a specialist. Preliminary evaluation of the eConsults initiated has found:

  • Approximately 56% actually required a face-to-face visit with a specialist, reducing the need for such visits by nearly half;
  • 36% were taken care of by the primary care provider with the specialists support and education;
  • 8% were assisted through re-direction of the eConsult.

“eConsult is a best practice example of the use and integration of technology accompanied with clinical workflow support to improve specialty care access and can serve as a model for other health care systems nationwide,” says Sajid Ahmed, Director of Health IT & Innovations at L.A. Care.

L.A. Care plans to expand the Safety Net eConsult Program to an additional 130 clinical sites throughout Los Angeles County in 2013.

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