Team-based Virtual Specialty Care Delivers Access and Advances Equity

Key Takeaways:

• While telemedicine has made great inroads post-pandemic, there is still work to do in making healthcare equally accessible
• Team-based care is a best practice in modern medicine today, empowering clinical teams to work together for optimal patient outcomes
• eConsults facilitate in-depth collaboration between primary care teams and specialists, improving access for underserved populations who may not otherwise have access to a physical or traditional telehealth specialist visit

The pursuit of equity remains a central mission of healthcare leaders, and it aims to ensure that every individual, regardless of their circumstances, has access to quality care. Yet, achieving health equity continues to be a challenge, particularly for underserved patient populations. From the elderly living with multiple complex conditions and polypharmacy, to patients living in remote or low-income areas and experiencing higher rates of chronic illness and mortality — fewer resources and less access makes it harder for healthcare teams to serve patients best. Enter virtual specialty care, bridging the access gaps while upholding the values of health equity. This team-based approach expands capacity for care, fostering collaboration between primary and specialty care clinicians, making it easier and faster to diagnose, treat, and educate patients. In this post, we explore how trending virtual care solutions like eConsults can help address chronic conditions better and make care more equitable for those who have historically been left behind.

Even with the rapid growth of virtual healthcare, disparities persist today. Not all patient groups enjoy equal access due to age, ethnicity, or other socioeconomic factors. According to a 2023 ASPE report, younger adults, those with higher incomes, private insurance, and more educated or tech-savvy are more likely to access telehealth — and enjoy higher quality care overall. However, key underserved patient populations could certainly benefit from a virtual care approach. For instance:

• The elderly are often burdened by prolonged health issues, complex medication regimens, and mobility obstacles — making it hard to even get to a single doctor’s visit. A recent study found that most seniors have at least two specialty care doctors, and nearly a third of them need to visit five different doctors every year!
• Another population facing distinct challenges are those living in remote geographic areas. Across the spectrum of chronic diseases – cardio-metabolic, respiratory, HIV, arthritis, and behavioral health disorders, and more – prevalence of illness is higher and outcomes are worse in rural US communities. Rural residents also have higher age-adjusted death rates compared to those living in urban, more accessible areas. The cause? Studies note the strong connection between limited primary care access and poor health outcomes for chronic conditions.

It’s time to close the gaps for vulnerable populations like these, improving care coordination and facilitating timely and cost-effective access to specialty care. And we look to our neighborhood healthcare heroes: The primary care team. Every day, dedicated primary care clinical teams join their talents and experience to support patients. Technology can help them meet challenges of addressing chronic conditions and promoting more equitable care. Leveraging modern technology and a team-based approach, eConsults expand capacity to appropriately treat patients within the primary care setting.

By connecting PCPs with specialists through secure online interactions, the primary care team remains at the helm of patient care. eConsults help avoid unnecessary services and referrals 70% of the time. For patients with multiple conditions, needing the expertise of several specialists, the PCP can more conveniently address their conditions, using multiple virtual consults, so that they can be treated within the primary setting. eConsults are also shown to foster a shared understanding of patient needs, facilitate knowledge exchange, and set the framework for rapid, comprehensive care planning. Case in point: Consider a fragile, homebound patient on twelve different medications. With an eConsult, the PCP can seamlessly engage with a trusted specialist to review the patient’s medications and confidently create a deprescribing plan — and the response can arrive in just a few hours.

The integration of primary and specialty care through a virtual platform transcends traditional boundaries, allowing for more patient-centered care. eConsults bypass the need for long waits for specialty visit referrals, which is critical for patients without easy access to in-demand specialists due to structural barriers. Speedier and more efficient virtual care, enabled by the primary care care team, translates to more comprehensive care and improved outcomes, particularly for those who have historically been marginalized by limited access. Now we can imagine a more equitable future for healthcare, where every patient receives the high-quality care they deserve.

About the Author

Dr. Laolu Fayanju, MD, MSc, is the Chief Medical Officer of RubiconMD, the leading provider of eConsults and virtual specialty care. Dr. Fayanju is a board-certified Family Medicine physician who was previously the Regional Medical Director for Oak Street Health in Ohio, where he continues to practice as a primary care physician.