Dell Medical’s pilot seeks to create scalable and updated referral process

Burhanuddin Calcuttawala

Dell Medical School began a pilot project three months ago aimed at expediting care to low-income and underinsured patients with musculoskeletal ailments by updating the referral process and shifting attention to value-based care.

The program has successfully cut down wait times for hundreds of patients who suffer from bone, joint and muscle disorders with the hopes that a successful initiative can be scaled to other branches of the healthcare industry.

Dr. Karl Koenig, director of the project and medical director for musculoskeletal care at Dell Medical, said the older referral process was often the cause of months-long waits, something the program is looking to reduce.

Koenig estimates 60 to 70 percent of primary care visits are related to musculoskeletal problems. 

“In the past, if your primary care doctor felt that you needed to have a consultation with a musculoskeletal provider, they would put in a consult and you would go into a queue,” Koenig said. “What we’ve done is take on that referral process so that the person who gets that referral, instead of being a secretary who puts it in the back of the queue, [is able to] look at those referrals and see if there is something we can do to help without having you come in.”

Dr. Mark Hernandez, chief medical officer of the Community Care Collaborative, said the initiative predicates the need for a redefined, value-based incentive system in health care. The CCC is helping fund Dell Medical School with $35 million of Travis County tax dollars annually.

“The way health care is provided today, it’s basically around a fee for service model, which means that … you get paid for what you do,” Dr. Hernandez said. “One of the things in this pilot is that … we’re not just piloting care delivery models, but we’re piloting [them] with value-based payment. Value is directly proportional to the outcome, and it’s inversely proportional to the cost.”

Nursing graduate student Lauren Cone said it is now her goal to be involved in an evolving health care industry with more efficient services for all patients.

“I would say that it is now, because I have seen access problems a lot more since I’ve been in graduate school than when I was as an RN,” Cone said. “Streamlining access … is hugely important. I see how much of a barrier lack of access is, and I’m glad this pilot program [is in place].”