ConcertoHealth, a globally capitated medical group managing 24,000 dual-eligible and Medicare patients, faced challenges in providing its patients with appropriate access to timely and effective specialist consultations. Ensuring this access is essential to preventing unnecessary hospital admissions, reducing emergency department (ED) admissions, lowering anxiety for patients and caregivers, and mitigating the burden and strain for primary care physicians (PCPs).
After a thorough evaluation process of available technologies, ConcertoHealth partnered with AristaMD, whose eConsult Platform facilitates communication between PCPs and specialists via eConsults. The HIPAA-compliant Smart Care Platform connects PCPs to a national, board-certified panel of specialists, who represent more than 70 specialty and subspecialty areas and return eConsults, often delivered within a few hours.
Additionally, AristaMD’s eConsult Platform offers ~400 clinical work-up checklists originally created by clinicians at the University of California at San Francisco (UCSF). These condition-specific guidelines include recommendations for clinical assessments, labs and diagnostics, ensuring the appropriate workup is completed every time. AristaMD eConsults provided timely and actionable feedback for ConcertoHealth providers.
This is just one example out of hundreds which showcase the capabilities of AristaMD’s solutions and services. AristaMD is a telehealth company dedicated to healthcare innovation. Their leading eConsult platform provides a telehealth solution that empowers primary care providers with clinical workup checklists and the ability to conduct electronic consults (also known as e-consults, eConsults or virtual consults) to significantly improve the patient referral process and allow greater access to timely, high-quality care. Designed to seamlessly integrate into clinical workflows, the eConsult platform allows payers and providers to quickly and cost-effectively launch specialist eConsults using their own specialists or those provided by AristaMD’s contracted panel of board-certified specialists.
The solution has proven to deliver cost-effective, timely access to specialty care through eConsults, significantly reducing the need for face-to-face visits. Committed to driving better health outcomes, AristaMD partners with healthcare stakeholders to ensure their success in the transition to value-based care.
Expanding Patient Specialty Medicine & Care Around the World
WoW Health Solutions, a U.S.-based international healthcare company, and AristaMD, a digital health company, announced the availability of electronic physician-to-physician consultations in Pakistan.
WoW Health Solutions is addressing the limited availability of specialty medicine and care by enabling its physicians in Islamabad, Pakistan to request eConsult, also known as electronic physician-to-physician consultations, from U.S.-based specialists. The relationship will further AristaMD’s vision of providing all patients with timely, cost-effective access to healthcare.
“Our mission is to make healthcare transparent, affordable, and accessible to all patients,” says Dr. Jawad Arshad, Emergency Medicine Physician & CEO of WoW Health Solutions. “Our Pakistani physicians and patients seek advice from oncologists and cardiologists as well as physicians with expert knowledge in other specialties. We chose to work with AristaMD because of the company’s innovative approach to specialty medicine and care. eConsults are a fast, effective way of obtaining confirmation of a diagnosis or treatment plan or a second opinion.”
The medical advice provided by electronic physician-to-physician consultation will supplement the limited availability of specialists in-country. The World Bank reports there are 1.1 physicians per 1,000 people in Pakistan versus 2.6 physicians per 1,000 people in the U.S.
“There is a significant need for specialist advice due to an overall shortage of physicians, particularly oncologists,” says Arshad. “Oncology consultations will inform treatment options based on the type of cancer diagnosed. Physician-to-physician consults will allow the physicians in Pakistan to provide better service and help us grow the direct primary care model in this market.”
In a direct primary care model, patients pay a monthly fee directly to the physician. In most cases, these patients don’t have health insurance or don’t have access to insurance. The monthly fee covers the primary care consultations. eConsults will enable these physicians to request second opinions or additional guidance about a treatment plan. For example, a cardiology consultation may provide guidance on whether the patient should consider bypass surgery, a stent, or a specific medication.
“Pakistan also has a high incidence of cardiovascular disease,” says Arshad. “With access to expert advice from a board-certified specialist, our doctors gain feedback about the patient’s treatment in cardiology, oncology, and other specialties. We also believe this will give their patients additional confidence in the diagnosis and recommended treatment plan.”
AristaMD’s eConsult and patient referral management platform facilitates collaboration between primary care and specialty medicine providers to expedite time to treatment, decrease costs and drive better patient outcomes. The WoW Health physicians trained in mid-March to request eConsults, will use the platform to improve patient outcomes related to several specialties. However, cardiology and oncology consultations are the program’s initial focus. The World Health Organization estimates that approximately 25% of Pakistan’s population over the age of 40 suffers from cardiovascular diseases. The estimate is driven by the prevalence of diabetes and hypertension, and more than forty percent of adult males are smokers.
“Requests for cardiology and oncology eConsults grew by 18% and 24% respectively from 2020-2021,” says Brooke LeVasseur, CEO of AristaMD. “Providers are now more comfortable requesting feedback electronically since the pandemic forced providers to leverage technology. Physician shortages and increased demand for healthcare services will drive continued growth. Like the U.S., Pakistan is experiencing growing demand for patient care and a lack of physicians. We are pleased to support timely, cost-effective access to healthcare wherever it is needed.”
WoW Health Solutions expects to make eConsults available to all their physicians in Pakistan. In the U.S., the company operates a comprehensive direct-pay marketplace that allows users to shop and access healthcare directly from medical providers who can offer their services at a steep discount because they are guaranteed their payments without having to submit any claims or paperwork.
“AristaMD is excited to offer our service internationally,” adds Brooke. “Our eConsult and referral management services lower healthcare costs and expedite care. AristaMD’s eConsult solution empowers physicians to expand their scope and collaborate on patient care with a world-class panel of on-demand specialists from anywhere in the world.
Latest Investment to Align Patient Needs
AristaMD recently announced the close of its latest financing to help integrate and expand services that increase patient access and lower healthcare costs. Cobalt Ventures joined existing investors including .406 Ventures, Ascension Ventures, Avalon Ventures, Cigna Ventures, CU Healthcare Innovation Fund, MemorialCare Innovation Fund and Stanford Health Care in the financing.
Cobalt Ventures, a wholly-owned subsidiary of Blue Cross and Blue Shield of Kansas City (Blue KC), selected AristaMD for investment because of its unique approach to coordinating care transition services. The investment will allow AristaMD to incorporate decision-support technology to suggest when an electronic consultation, or eConsult, can be used to provide specialist advice about a patient’s care and alert providers when patients are eligible for healthcare services related to the patient’s care needs. With these improvements, AristaMD seeks to accelerate care, health equity and improve both access and outcomes while reducing the overall cost of diagnosis and treatment.
“We seek out opportunities to invest in technology, like AristaMD’s platform, which improves healthcare quality and outcomes, while lowering costs,” says David Eichler, President and Managing Partner of Cobalt Ventures. “AristaMD is developing tools that connect primary care providers with specialist advice and care transition services when and where that advice and care is needed. This investment aligns well with our focus on alternative care delivery and financial and operational value-creation for all industry stakeholders—patients, providers, and payers.”
AristaMD’s eConsult and referral management services provide benefits for the referring physician, the specialist, and the patient by improving access and health equity, enhancing communication, and triggering automatic follow-up. While the platform delivers services to physician practices it also scales to meet the needs of regional and national payers. The referral management application allows hospitals, health systems, accountable care organizations (ACOs), and health insurance companies to quickly route patients to the appropriate care delivery setting, including virtual physician-to-physician consultation or in-network, onsite specialty care.
“With the growth of value-based care payment models, providers, health systems, and payers are focused on high-quality, cost-effective care delivery,” elucidates Brooke. “Responding quickly to a patient’s need for specialist care and choosing the appropriate care setting and support services impacts patient outcomes and financial performance. This investment will help to create more timely, cost-effective access to health care for patients.”
Towards the Future
It is pertinent to mention that the company recently acquired the acquisition of Preferral, a platform for referral management, analytics and document routing.
Combining virtual physician-to-specialist consultations, or eConsults, with a referral management platform that optimizes the selection of specialists for face-to-face referrals will help AristaMD in its mission of using technology to facilitate collaboration between healthcare providers. Both solutions are designed to expedite time to treatment, decrease costs and drive better patient outcomes.
“Today’s referral paradigm is broken. It is estimated that 20 million clinically inappropriate referrals are sent each year and that more than 20% of referrals are misdirected. In addition, up to 50% of referrals are often unfulfilled”, says Brooke. “All of these dynamics lead to patient frustration, inflated costs and poorer patient outcomes. Electronic referral management and eConsults are simple-to-implement tools that improves the quality of referrals, increase patient compliance, improve provider communication and reduce unnecessary spend.”
The combined company will provide a comprehensive, end-to-end referral solution to meet the needs of payers, health systems, Accountable Care Organizations (ACO), primary care providers and specialists. The integrated solution will provide the tools needed to ensure patients are being treated by the right provider, in the right setting – as quickly and cost-effectively as possible.