Patients and FHC: Love or Hate Relationship Patients and FHC: Love or Hate Relationship? NHCS Series Part III February 14, 2008 Marfatia Support: Vikram Arora, MD Shannon Bolon, MD Lauren Jonkman, PharmD Ruta, Marfatia, MD Katie Sullivan, PharmD Stephen Wilson, MD Presenters: Megan Barkell, PharmD Stanley Chan, MD (Jihad Irani, MD) Jennifer Middleton, MD Laura Miller, MD

NHCS Curriculum Goals Consider innovative ways of delivering patient care in the outpatient setting Define the process for implementing any practice-based change Understand the barriers to developing a new health care system and methods of overcoming these barriers Critically evaluate proposals for health care reforms

NHCS Series: Part I EHR add on’s Instant medical records E-visit QI projects and practice improvement Online portal E-prescribing One sentence about each IMR – allowing transparency to patients and the ability for patients to update and view medical records anywhere at anytime. Improves efficiency. Facilitates the office visit E-visit… Virtual office visit QI projects… patient registry for chronic disease management and health maintenance. Online portal is a patient portal – a portable, accessible patient health record. (home) – way to … allows patient schedule appointments, pay bills, obtain labs, get RX renewals, virtual office visit E-prescribing… fast approach to sending prescriptions electronically to pharmacies to decrease errors and increase satisfaction.

NHCS Series: Part II Healthcare reform debate Current system Employer mandate Individual mandate Public program expansion Single payer: National Health Insurance Current system: support the status quo Employer mandate.. For working men and women The All for One Individual Mandate with allow all persons to have accessible healthcare coverage regardless of income, social or economic status Single payer: The program would be a combination of social insurance and public assistance in which we all pay into the health care fund. Public program expansion: By expanding eligibility of the existent programs, we can create a patchwork of coverage for the uninsured and underinsured, while leaving the private insurance market intact. Which one won??

Today’s Objectives Contrast two ways of office operations List ways to improve office efficiency Discuss methods of developing patient-centered care

Overview: Scenario 1 vs. Scenario 2 Pre-visit Patient-physician encounter Ancillary services First scenario– is the patient check in … take notice to the different tools, techniques for each, Patient resident RN and receptionist– Megan picks 5 volunteers for Laurie’s skit – will hold signs far apart from each other

Pre-visit: Scenario 1 Pick residents 1 for receptionist – behind podium 2nd for RN – send to door

Pre-visit: Scenario 2

Fingerprint Recognition

Computer Check-in

Pre-visit Discussion What are some benefits and barriers associated with each scenario? Please have some answers to questions too 1st way cheaper?? Cost with second scenario Time saver with second scenario Education for patients while in doctor’s office

Encounter: Scenario 1

Encounter: Scenario 2

Reviews Patient’s E-history

Screen Freezes

Reviews Patient History in PDA

Patient-Physician Encounter What differences did you see between the 2 settings (tools, techniques etc.)? What worked well, what didn’t? What did you think of the transparency??

Ancillary Services: Scenario 1

Labs

Pulmonary Function Test

Allergist

X-Ray

Pharmacy

Ancillary Services: Scenario 2

Medical Home

Ancillary Services What are some barriers associated with each way? How did these scenarios incorporate patient-centered care? All in one place Website to find out results of tests with patient having full access

Wrap-up Waste The patient’s needs Transparency What did you observe? How might it be decreased? The patient’s needs Anticipated? Ways to do so? Transparency Benefits Drawbacks What were some of the EHR add’on’s and List ways to improve office efficiency Discuss methods of developing patient-centered care What are some of the barriers to implementation of …. How did the pre-visit differ between the two approaches? What were some ways that the patient-physician encounter improved office efficiency in either approach? Contrast two ways of office operations Where were they? EMR E-visit E-prescribing Decreased waste? Do you think one way improved patient-centered care? How?

Wrap-up Team approach to care What would need to change to make a team work? Medical home What elements of a medical home do we already have at the FHCs? What’s missing? What were some of the EHR add’on’s and List ways to improve office efficiency Discuss methods of developing patient-centered care What are some of the barriers to implementation of …. How did the pre-visit differ between the two approaches? What were some ways that the patient-physician encounter improved office efficiency in either approach? Contrast two ways of office operations Where were they? EMR E-visit E-prescribing Decreased waste? Do you think one way improved patient-centered care? How?

Happy Valentine’s Day