Patient access

Strengthening access to high-quality health care

Across UVM Health Network, our staff and clinicians are making it easier for our patients to receive the care they need, when they need it.

Together we are:

Using new technologies to strengthen access to specialty care

When Jack Galt’s cardiac stress test suggested there was a problem, he wanted answers fast. Rather than waiting for an in-person appointment, Galt quickly received insight from a cardiologist with an eConsult – one of the many new digital tools connecting our patients more quickly with care.

Our new digital tools connecting people with health care providers

Ensuring timely access to surgical care

When you’re in pain, waiting for a surgical appointment can feel like an eternity. Such was the case for Susan Anderson, who needed both of her hips replaced last year. “I wanted to go to UVM Medical Center for the procedures, but unfortunately the wait was just too long,” says Anderson.

Our work to increase local surgical care options

Breaking down financial and personal barriers to care

While timely appointments are important, many people struggle to get high-quality care due to health care costs and other personal challenges, such as a lack of reliable transportation, access to healthy food and more.

Our programs to help people overcome barriers to health care

The collective goal of all these efforts, across our entire health system, is to give our patients the best possible experience. We know we can’t achieve this goal if people in our communities are looking at long wait times for care. We must do better, and thankfully we’re seeing progress.

Sunny Eappen, MD and MBA, UVM Health Network’s president and chief executive officer

Using new technologies to strengthen access to specialty care

As a primary care physician of more than 25 years,

Marie Sandoval, MD, has seen many routine patient visits unearth a serious health concern requiring follow-up care and specialist expertise. Such was the case in late November 2023, when Jack Galt, a long-time patient walked in for his annual visit. He mentioned feeling pain in his chest while riding his bike.

To investigate, Dr. Sandoval conducted tests of Galt’s heart and, concerned by the results, needed the insight of a cardiologist.

In the past, Dr. Sandoval would have needed to refer Galt for an in-person cardiology appointment, have him schedule that appointment, and then wait until it arrived to find out what was wrong and what could be done about it. But instead, Dr. Sandoval submitted an eConsult – a rapid, digital consultation between primary care and specialist providers.

“The eConsult bypassed a lot of back and forth and got me a wealth of information really quickly,” says Galt. “I found out that I had blockages in the arteries around my heart, which was causing the pain. I’ve been going to cardiac rehabilitation since then, which has been a fantastic experience – I’ve been feeling so much better by just making some adjustments to my daily health regimen.”

And by allowing primary care givers access to specialty expertise through eConsults, specialists are more freed up for in-person appointments.

Growth and impact of the econsults program

20

specialties offer eConsults, including endocrinology, cardiology, pulmonology and rheumatology

1,770

eConsults ordered in 2023, the first year of its use

3,600

estimated eConsults for 2024, with a goal of 4,000

11%

increase in available in-person appointments at some specialties

381

eConsults ordered in May 2024, the single highest usage within one month

eConsults are just one piece of the puzzle. Teams across the health system are developing new technology-enabled tools to make patient access to care as easy as possible.

 

Linking providers to specialist expertise during patient emergencies with telemedicine

Mobile telemedicine carts at each of the health system’s six hospitals, and other community and regional hospitals, connect providers with specialist expertise during emergencies, such as a person experiencing a stroke or a newborn baby who requires intensive medical care or transportation.

Quickly connecting stroke patients to neurology specialists with the Telestroke program

Telestroke helps give stroke patients a better chance of making a full recovery by quickly connecting them with neurology specialists, even if it is based at another location.

Providers have used telestroke nearly 500 times since 2021, and a growing number of hospitals outside of UVM Health Network are also benefitting from the expert care available through the program.

Reducing duplicate imaging procedures for patients with Unified Picture Archiving and Communication System

Our new system cuts back on duplicate imaging procedures, like MRIs or CT scans, helping reduce costs for patients and making it easier for them to access the care they need by preventing scheduling logjams.

Empowering patients to schedule their own appointments with self-scheduling options

Within the coming months, self-scheduling options will allow patients to find and schedule their own appointments with their primary care provider, an option that will be expanded in the future to include specialist visits as well.

And, as of June 12, 2024, we launched Fast Pass, which offers unused appointment slots to patients via a MyChart message. In just the first few weeks from launch, we had nearly 190 “offers” accepted by patients, resulting in an average improvement of appointment times by 49 days for family medicine and 43 days for general internal medicine.

Taken together, all of these [technology-enabled] initiatives will make it much easier and more convenient for people to get the care they need. There is so much potential in this space.

Todd Young, associate vice president of digital health services at UVM Health Network artificial intelligence in certain care settings

Ensuring timely access to surgical care

Beyond these initiatives, we can reduce wait times for surgical care through high-quality equipment and efficient facilities.

When you’re in pain, waiting for a surgical appointment can feel like an eternity. Such was the case for Susan Anderson, a long-time resident of Chittenden County who needed both of her hips replaced last year.

I wanted to go to UVM Medical Center for the procedures, but unfortunately the wait was just too long. I needed to ask my son to come home from Singapore to drive me, and it was a long, painful series of car rides. It would have made a world of difference to have this procedure done here locally.

Susan Anderson, who went on to get her hips replaced at an out-of-state facility.

Stories like Anderson’s, and the ripple effects of limited operating room availability, underscore the importance of increasing local options for people who need surgical care.

“I’ve lost sleep knowing that we can’t get them in,” says Fuyuki Hirashima, division chief of cardiac and thoracic surgery at UVM Medical Center, who points to the hospital’s limited operating room space as problematic to its ability to perform life-saving surgeries, now and in the future.

Opening a multi-specialty outpatient surgery center in South Burlington, Vermont, is part of a carefully planned strategy to provide expert care for patients as close to home as possible and in the most appropriate setting.

 

 

Today, many procedures are performed in the main hospital that would be better suited to an outpatient environment. Moving these cases to an outpatient surgery center will also allow UVM Medical Center to expand and improve its main campus for complex and urgent life-saving surgeries.

The center is currently in the final stages of review by the Green Mountain Care Board.

Breaking down financial and personal barriers to care

Access to health care is about more than timely appointments.

While timely appointments are important, for some, health care costs are the primary barrier to care. “As a nonprofit health system, we want to make sure we do everything we can to ensure that cost doesn’t prevent patients from getting the care that they need. This is an important way for us to help provide equitable access to lifesaving health care.” states Sunny Eappen, MD and MBA, UVM Health Network’s president and chief executive officer.

UVM Health Network runs several programs to help people overcome barriers to quality health care:

 

Health and Financial Assistance Programs

In 2023, our health and financial assistance programs helped 6,368 patients obtain vital medication and supported hundreds more to enroll in health insurance and other state and federal programs, or access other critical health resources through the team’s advocacy and support. Overall, these programs covered $7.5 million in costs last year that would have come out of our patients’ pockets for medication.

 

Care Management

Across the health system, dedicated teams helped more than 3,500 patients connect with support services, known as care management, to help them overcome personal barriers to care and better manage their health. In a recent survey, nine out of 10 patients said they understood their health concerns better after receiving care management support and reported being able to manage their health more independently.

Patients enrolled and engaged end up needing less medical care:

32% reduction in primary care visits

42% reduction in emergency department visits

41% reduction in hospital stays


Our aim as a health system is to provide the most comprehensive, effective, and efficient health care we can, and that means looking beyond the exam room into our patients’ day-to-day lives. For many Vermonters and New Yorkers, economic, logistical and personal considerations pose serious obstacles to their ability to receive care. The best diagnosis or treatment can only go so far if the patient lacks reliable transportation or access to necessities like healthy food.

Jessica Moschella, senior vice president of high value care at UVM Health Network