Despite their investments in access expansion, most physician organizations continue to struggle to improve access to specialty care.
According to a recent survey by Merritt Hawkins, the average appointment wait time for specialty care in 15 major markets was 24.1 days in 2017, a 30.3% increase from 2014. And in some specialties, such as dermatology, wait times are climbing to more than one month.
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While many providers may now find themselves with more availability than usual as a result of Covid-19, specialty care volumes will likely take longer to rebound than primary care as referrals lag. To capture volumes as quickly as possible, organizations must prioritize timely access now more than ever—such as by exploring new ways to apply telehealth technologies in specialty care. Sharp Rees-Stealy, a medical group based in San Diego, deploys EHR-based digital consults (also called "e-Consults") to give patients and primary care providers (PCPs) faster access to specialists.
A few years ago, Sharp Rees-Stealy built a "Curbside Consult" program in its EHR after realizing that specialists often spent time on appointments that didn't require in-person care or could be adequately handled by a PCP. Under the group's program, the referring physician sends a message, and oftentimes a photo, via EHR to the on-call physician for that specialty.
After receiving the request, the specialist reviews it and decides whether a referral is necessary. Frequently, the specialist determines that an in-person visit isn't needed, and that the patient can be effectively managed in primary care, with virtual input by the specialist ad hoc. But even if it's determined that an in-person visit is needed, the specialist often recommends a treatment regimen that the PCP can start the patient on in the interim. Not only does this approach expedite patient care, but it also helps bypass the initial consult, saving an in-person visit. Sharp Rees-Stealy aims for a two-day turnaround time for these requests and has scaled the program across 15 specialties.
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