Dr. Delphine Tuot of the UCSF Center for Innovation in Access and Quality (CIAQ) and Dr. Nwando Olayiwola of the UCSF Center for Excellence in Primary Care (CEPC) were recently awarded a Blue Shield of California Foundation technical assistance grant for spreading adoption of eConsults in the safety net. eConsultation and referral systems (eCR) are delivery system innovations that enable primary care providers and specialists to consult electronically about a patient’s conditions, determine the optimal manner of care, and engage in effective co-management of patient conditions. Pilot testing of eCRs has taken place at San Francisco General Hospital, the University of California, San Francisco, the Los Angeles Department of Health Services, and the L.A. Care Health Plan. The strong successes of eCR models in Los Angeles and San Francisco has generated interest in adoption of the model from safety net healthcare providers around the state. CIAQ is partnering with the CEPC and Community Partners to provide technical assistance to 6 California county systems on various stages of eCR design, implementation, adoption, spread, and sustainability, with the goal of creating efficient and robust eCR systems throughout the safety net in California.