Special Projects Fund

Grantee Name

University of Rochester

Funding Area

Special Projects Fund

Publication Date

April 2013

Grant Amount


Grant Date:

January 1, 2009 – December 31, 2010

For many parents, particularly those in impoverished, inner-city communities, the emergency department is their only access point for medical care for children with acute illnesses.

However, limited primary care access often leads to exorbitant costs for non-emergency conditions, and for care that is frequently inconvenient, impersonal, and inefficient. To ultimately change this paradigm, the University of Rochester piloted the Health-e-Access program over the course of nine years, beginning in 2001. The program enables children with acute or ongoing health care needs to be evaluated by a remote clinician via telemedicine in convenient, community-based access sites, which include childcare programs and schools.

The program facilitates early access to care within a primary care medical home, and reduces unnecessary and costly emergency department visits. This in turn allows working families and single parents to more effectively balance their personal and professional needs. Previous research shows that the Health-e-Access model cuts down on workplace absences due to sick children by 63%, retains 87% of primary care medical home patients, and reduces health system costs by 22% due to fewer emergency department visits.

A grant from NYHealth in January 2009 enabled the University of Rochester to expand the Health-e-Access program and reach more patients.

Outcomes and Lessons Learned

  • Established after-hours neighborhood telemedicine access sites at Strong Memorial Hospital and four additional inner-city locations, leading to a 242% increase in neighborhood after-hours visits from 2009 to 2010 (128 visits in 2009 increased to 438 visits in 2010);
  • Completed extensive work to fully integrate Health-e-Access into the regular phone triage system in the pediatric practice at Strong Memorial Hospital, including the development of simple scripts and protocols to help nurses quickly determine which complaints are eligible for telemedicine; and
  • Facilitated negotiations among local insurance organizations, primary care providers, and Health-e-Access regarding a telemedicine facility/technology fee.