title: Improving the electronic nexus between generalists and specialists: A public health imperative?
abstract: Recent changes in healthcare delivery and payment policy have precipitated interest among healthcare providers across the U.S. seeking innovative strategies to achieve higher quality, lower cost care through improved resource-utilization. One dimension of healthcare delivery with distinctive potential for improvement is care coordination between primary care and specialist providers. Optimizing the nexus between PCPs and specialists through innovations including eConsultation platforms portends reductions in unnecessary referrals and testing, and may help align incentives to promote high-value care. Opportunities and challenges surrounding effective and versatile operationalization of such technologies are assessed, focusing on specific public health needs of access and utilization.
authors.affiliation: Massachusetts General Hospital, Harvard Medical School, 260 Longwood Avenue, Boston, MA, USA. Electronic address: michael.young@mgh.harvard.edu.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Young
authors.affiliation: Dorchester House Community Health Center, Boston, MA, USA.
authors.forename: Julien
authors.initials: J
authors.lastname: Pham
mesh_terms: D003266:Continuity of Patient Care; D003695:Delivery of Health Care; D006297:Health Services Accessibility; D006801:Humans; D008490:Medical Informatics; D011320:Primary Health Care; D011787:Quality of Health Care; D013038:Specialization; D017216:Telemedicine
keywords: Access to care; Care-coordination; Econsults; Specialists; Underserved