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As health systems adapt to focus increasingly on maximizing
the value of care they deliver, more and more are coming to recognize the
importance of improving efficiency and quality at the interface of primary care
and specialty care.
With every referral, there is a risk of fragmentation of
care. Poor communication leads to poor coordination, and poor coordination of
care often creates gaps in quality and higher costs that undermine the goal of
Fortunately, these are problems that can be solved, as the health
systems and programs in this report demonstrate. Pioneered at three health
systems in the United States – Kaiser Permanente Colorado, Mayo Clinic, and
University of New Mexico Health Sciences Center – the innovations described in
this report share a commitment to efficient use of provider time, teamwork, and
training to improve both health outcomes and the patient experience of care.
The three profiles in this report outline:
- Five initiatives at Kaiser Permanente Colorado: advice referrals; real-time virtual consults; primary care liaisons; population management programs within specialty care; and educational opportunities and
resources for physicians.
- Three initiatives at the Mayo Clinic: the use of electronic consultations (eConsults) among physicians; the embedding of specialty-trained nurse practitioners and physician assistants in primary care clinics (and primary care physicians in specialty departments); and the development of care process models that define roles and relationships between primary and specialty care in the management of particular conditions.
- Details about Project ECHO at the University of New Mexico Health Sciences Center,
which developed teleECHO clinics and community health worker training programs that aim to improve health outcomes for people living in rural and other medically underserved areas of New Mexico by more equitably distributing the specialized knowledge and health care delivery practices concentrated at academic health centers.
Download the report to discover how the innovations
at these health centers:
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the ability of primary care providers to tap into the expertise of their
specialist colleagues with minimal disruption to the workflow.
access to specialty visits for patients who need them.
costs of care and increase convenience for patients.