The Middletown Press (Middletown, CT)
NONPROFIT
Rather, the people involved say, it enables a specialist to see far more people.
Dr. Chris Norwood, a dermatologist at Starling Physicians in New Britain and Rocky Hill, recently handled 20 e-consults on a Thursday this month — all through Community eConsult, with patients from Washington state to Maine, many from Connecticut.
He could have seen maybe five patients in person in that same time, he said. Appointments can normally take weeks or months to set up, but if he sees a patient electronically who’s got a grave issue,” they can get in to see me sooner.”
Specialists send back a response within two days, usually faster, and they can go back and forth with requests. Norwood sometimes asks for clearer pictures, or pictures of a patient’s fingernails.
For this, he collects a modest, some would say meager, $35 per electronic consult. Payment systems across the country, for Community eConsult and competitors, are still evolving and the best tend to be the systems that pay flat rates for overall patient care, rather than fee-for-service.
“I wouldn’t call it profitable but it’s not an enormous money sink and I think it does help the community greatly,” Norwood said. “No one is buying a Ferrari with this.”
Electronic consults started with the Veterans Administration, which has been doing them for decades, Anderson said. Then it spread to San Francisco — no surprise there. Anderson, who has a Harvard undergrad degree in chemistry, his medical degree from Columbia University and his residency at Yale — where he later taught on the faculty — rejoined CHC in 2010 after an earlier stint as a doctor for the center.
He’s vice president and chief quality officer at CHC, and director of the Weitzman Institute, which was named in memory of the owner of Pelton’s Pharmacy, an early supporter of CHC.
“My goal had always been to work with the underserved,” Anderson said.
And he was the first to launch wide studies of the e-consult practice, soon after he rejoined CHC.
Patricia Baker, CEO of the Connecticut Health Foundation, said community health centers have long had trouble getting their patients in to see specialists, which is why electronic consultations advance the foundation’s goals.
“It is a powerful program for providing care and making that care cost effective, and improving access,” Baker said, but she added, rates need to be set to make that happen.
In a written statement, the state Department of Social Services said it’s committed to the technology and will soon issue new rates — after an increase on Jan. 1 that replaced a comically low rate.
It’s all part of lurching toward a future that uses technology for visits, not just treatment.
In 10 years, Anderson said, “Some of our consult needs will be met through artificial intelligence, some will get an e-consult, some will get telehealth visit where you talk directly by videoconference . ... What we say is, move knowledge, not people.”