Notes and Disclaimers:
- Projects shown may also be operating in other states (see the Geographic Reach)
AMERICAN COLLEGE OF CARDIOLOGY FOUNDATION
Project Title: "SMARTCare"
Geographic Reach: Florida, Wisconsin
Estimated Funding Amount: $15,871,245
Summary: The American College of Cardiology Foundation project will test the implementation of SMARTCare, which is a combination of clinical decision support, shared decision-making, patient engagement, and provider feedback tools designed to improve care for patients with stable ischemic heart disease. SMARTCare aims to achieve the following goals: 1) a reduction of imaging procedures not meeting appropriate use criteria, 2) a reduction in the percentage of percutaneous coronary interventions not meeting appropriate use criteria while achieving high levels of patient engagement and lower rates of complications, and 3) an increase in the percentage of stable ischemic heart disease patients with optimal risk factor modification. While many of these solutions have been studied and proven effective in isolation, this project will test them in combination. The model will be tested at five sites in Wisconsin and five sites in Florida.
ASSOCIATION OF AMERICAN MEDICAL COLLEGES
Project Title: "eConsults/eReferrals: Controlling Costs and Improving Quality at the Interface of Primary Care and Specialty Care"
Geographic Reach: California, Iowa, New Hampshire, Virginia, Wisconsin
Estimated Funding Amount: $7,125,770
Summary: The Association of American Medical Colleges project will test the scalability of an eConsult/eReferral model for implementation in five partner academic medical centers. The eConsults model, developed by the University of California San Francisco (UCSF), is an electronic consultation and referral (eCR) platform for access to specialty input to address several well-documented gaps in primary care-specialty care communication and coordination and provide a foundation for non-face-to-face, asynchronous electronic consultation. The proposed model has two components, both fully integrated into the Epic electronic health record. The first being implementation of a standardized set of condition-specific referral templates across 12 medical specialties, with additional surgical specialties nearing completion. These templates, developed at UCSF and refined at each academic medical center by a consensus of primary care/specialist clinicians, provide immediate decision support to the primary care provider (appropriateness of referral, recommended pre-referral tests, etc.) and ensure that all necessary information is provided to the appropriate specialist. The second component of the model is the eConsult, an asynchronous exchange initiated by the primary care provider to seek guidance from the specialist, who is expected to respond in less than 72 hours. eConsults are completed in lieu of an in-person specialist visit, though the specialist can convert an eConsult to a referral if the situation warrants and the patients will still have the option to seek care with that specialist, if desired. The eConsult system integrates into current care-delivery practices and supports the work of both the primary care provider and the specialist involved in an eConsult exchange.
WISCONSIN DEPARTMENT OF HEALTH SERVICES
Project Title: "Special Needs Program for Children with Medical Complexity"
Geographic Reach: Wisconsin
Estimated Funding Amount: $9,457,875
Summary: The Wisconsin Department of Health Services project will test an intervention that aims to enhance and expand the Special Needs Program (SNP) model that is currently in place at Children's Hospital of Wisconsin (CHW). The model establishes a dedicated care team consisting of physicians, nurse practitioners, nurse care coordinators, lay navigators, and other ancillary staff as necessary to work specifically with those children with some of the highest ongoing medical needs. The care team works with the children through every step of the process, coordinating care across specialists, educating the family on care transitions and how to best care for children in the home, and communicating care plans with local primary care physicians. The intervention has been in place in a more limited format at CHW for over a decade, and has proven results of reducing inpatient hospital costs by more than 50%. This proposal also expands the SNP to an ambulatory setting, allowing for identification of high-needs children who may not be at an inpatient hospital need of care, but still have high medical complexity. A third arm of this proposal is that the SNP model (intensive inpatient focus) will be expanding to a second tertiary pediatric center in Wisconsin to test scalability of the intervention.