UVM Health Network Launches eConsults for Better Access to Specialty Care

BURLINGTON – The University of Vermont Health Network announced today the first phase launch of eConsults, which allow patients to receive expert consultation from specialty physicians directly through their Primary Care provider. In appropriate cases, specialists will be able to weigh in without needing to schedule an additional in-person appointment – improving patient care and also opening up more specialty appointment slots for patients who do need to be seen in person.

The technology is currently available in pilot form at UVM Medical Center South Burlington Adult Primary Care for appropriate Sleep, Psychiatry, and Pharmacy consultations. In addition, all UVM Medical Center Adult Primary Care and Family Medicine sites now have access to Hepatitis-C specialists.

“eConsults has great potential to improve the experience of our patients by giving them faster access to specialty care through their Primary Care provider,” said John R. Brumsted, M.D., President and CEO of the UVM Health Network. “This launch is a key milestone of our Access Action Plan and we will continue to expand eConsults across the Network to benefit our patients across the entire region. I am incredibly grateful to the clinical and administrative teams whose work made this service possible for our patients.” 

Primary care physician Marie Sandoval, MD, outlined the benefits of eConsults for patients and providers. “I have been a primary care doctor for 23 years. When we transitioned from paper charts to electronic charts twelve years ago, I kept hoping we would be able to leverage the technology to help patients in exciting new ways. E-consults will do this by getting our specialists’ opinions quickly for patients with straightforward clinical questions. I believe this will be an opportunity to enhance patient care, while at the same time opening up more specialty appointment slots for patients who do need to be seen in person.”

In many instances, a patient’s Primary Care provider is their first and best stop for preventative and diagnostic care. However, for patients who require specialized care, their Primary Care provider will typically refer them to a specialty provider for further evaluation and treatment. Historical trends, a recent increase in demand for health care services after patients delayed care in the early stages of the COVID-19 pandemic, and a national health care workforce shortage have combined to result in unacceptably long wait times for specialty care. The eConsults technology will allow many Primary Care providers to receive advice and treatment plans from specialists without the need to refer patients for another appointment – leading to care being delivered faster and more conveniently in the primary care medical home, and reducing the backlog for in-person specialist visits.

The multi-year implementation of eConsults is a key component of the Network’s recently released Access Action Plan, focusing specifically on the goal of reducing wait times for specialty care. The technology supporting eConsults is available thanks to the multi-year investment the Network has made across its affiliates in a shared electronic health record (EHR), Epic. Since the eConsults technology is built upon the Epic EHR, expansion of the service will continue as Epic is adopted in all Network hospitals and clinics in Vermont and Northern New York.

eConsults was originally piloted by the American Association of Medical Colleges (AAMC) Project CORE: Coordinating Optimal Referral Experiences beginning in 2014. In the first three years of the pilot, hospitals participating in the program saw an 84 percent increase in timely access to specialty care and opened up thousands of in-person specialty appointments. Through this multi-year implementation, we anticipate increased access to specialists as eConsults is expanded throughout the Network and will be monitoring progress.

The eConsults Process

• A patient’s Primary Care provider determines that the next step of the care process is to receive additional input and expertise from a specialty provider.
• With consent from the patient, the Primary Care provider initiates an eConsult with a specialist through the Epic electronic health record system. No referral or scheduled appointment is needed for the patient.
• The Primary Care provider discusses the patient’s care needs securely with a specialist.
• Within one week, care feedback from a specialist is available to the Primary Care provider and on the patient’s MyChart portal.
• Following review of the specialist’s feedback, the Primary Care provider will reach out to the patient to discuss care plan options.

Supporting Policy to Enhance Telehealth

Efforts such as eConsults are possible with public policy advances at the federal and state levels covering new and innovative ways to deliver care across regions and settings. This is especially true in Vermont, where laws have been passed requiring coverage for audio-only telehealth, asynchronous telehealth, provider-to-provider telehealth, and telehealth delivered to patients both in and out of a health care setting. These changes in the law are thanks to collaboration between providers and policymakers, seeking to adopt strategies to ensure access regardless of where patients and providers are, and their ability to travel to receive their care. 

Taking Action to Improve Access

The launch of eConsults technology is one component of the Network’s Access Action Plan, which addresses three goals: reducing wait times for specialty care, hiring successfully amid national staffing shortages, and improving hospital inpatient and emergency capacity. Last week, the Network announced a partnership with the State of Vermont, Burlington Health and Rehab, and Birchwood Terrace Rehab & Healthcare to ensure patients are receiving the appropriate level of care by staffing long-term care facilities and transferring those patients from UVM Medical Center, freeing up vital inpatient bed space.

In addition to eConsults, the Network’s Access Action Plan identifies further initiatives to reduce wait times for specialty care, including:

• Completing the second and third phases of the multi-year Epic electronic health record installation. All Vermont hospitals and clinics will be on the system by November 2021 and all New York hospitals and clinics will be on the system by April 2022.
• With our approved conceptual Certificate of Need, we are planning for a new outpatient surgery center to replace the outdated Fanny Allen surgery space and expand overall surgical capacity.
• Expanding the Patient Access Service Center by adding 19 new employees and increasing centralized scheduling capabilities.
• Launching patient self-scheduling through the patient portal MyChart in order to improve the scheduling experience for existing primary care and selected specialty care patients in FY22, with further expansion in FY23.
• Increasing the use of telehealth appointments and improving the workflow of telehealth visits.

Any patient who is having trouble accessing care in a timely manner should first call their doctor’s office. If additional help is needed, our Patient and Family Advocates are ready to assist.

Vermont

• Central Vermont Medical Center: (802) 371-4350
• Porter Medical Center: (802) 388-4701
• UVM Medical Center: (802) 847-3500

New York

• Alice Hyde Medical Center: (518) 481-2258
• Champlain Valley Physicians Hospital: (518) 314-3054
• Elizabethtown Community Hospital: (518) 873-6377

About The University of Vermont Health Network

The University of Vermont Health Network is an integrated system serving the residents of Vermont and northern New York with a shared mission: working together, we improve people’s lives. The partners are:

• The University of Vermont Medical Center  
• The University of Vermont Health Network Medical Group
• The University of Vermont Health Network – Alice Hyde Medical Center
• The University of Vermont Health Network – Central Vermont Medical Center
• The University of Vermont Health Network – Champlain Valley Physicians Hospital
• The University of Vermont Health Network – Elizabethtown Community Hospital
• The University of Vermont Health Network – Porter Medical Center
• The University of Vermont Health Network – Home Health & Hospice

Our 4,000 health care professionals are driven to provide high-quality, cost-efficient care as close to home as possible. Strengthened by our academic connection to the University of Vermont, each of our affiliates remains committed to its local community by providing compassionate, personal care shaped by the latest medical advances and delivered by highly skilled experts.

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