AAMC Project CORE: Coordinating Optimal Referral Experiences - California

Program Location: 
San Francisco, CA
Payer Type: 
Grant
Partner Organizations: 
University of California San Francisco
Dartmouth Hitchcock Medical Center
University of California
San Diego Medical Center
University of Iowa Hospitals
University of Virginia Medical Center
University of Wisconsin Hospitals
Description: 

The Association of American Medical Colleges received a CMS Health Care Innovation Award to fund scalability testing of an electronic consultation and referral system for implementation at five partner medical centers. The model, developed by the University of California San Francisco, aims to address gaps in primary care-specialty care communication and provide technology for non-face-to-face electronic consultation. Seeking to leverage Electronic Medical Record systems, improve access to specialists, and enhance the patient experience, the project looks to improve quality and efficiency in the ambulatory setting.

The AAMC will partner with a pioneer in this delivery model, the University of California-San Francisco, to disseminate the model to five academic medical centers (AMCs) – Dartmouth-Hitchcock Medical Center, University of California, San Diego Medical Center, University of Iowa Hospitals & Clinics, University of Virginia Medical Center, and University of Wisconsin Hospitals & Clinics. These AMCs serve a collective population of more than 500,000 primary care patients, who are the targeted beneficiaries of this innovative care model.

The award amount is $7,135,770 over a three year period.  

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 .

Improved Patient/Clinician Satisfaction: 
  • 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*
Improved Access: 
  • 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*
Other Outcomes: 

*Based on overall program data, not state-specific

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