Free Essay About Fremont Family Care - Davies Ambulatory Award Winner

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Abstract

Since 1994, the HIMSS Nicholas E. Davies Award of Excellence was awarded to for outstanding achievement in utilizing health IT to generate improvement of care outcomes and improve ROI. The Davies Award program promotes EHR-enabled improvement in patient outcomes through sharing best practices and lessons learned on implementation strategies, analytics, workflow design, and change management. Fremont Family Care is part of Health Care Professionals which is a wholly owned 501(c) -3 subsidiary of Fremont Area Medical Center (FAMC). It is the 2014 HIMSS Ambulatory Award winner and this report demonstrates how Fremont Family Care utilized electronic health record enabled dashboards, clinical decision support, and data to drive a culture change that has significantly improved quality outcomes.
Keywords: HIMSS Ambulatory Awards, HER, EMR, Fremont Family Care

Davies Ambulatory Award

Davies Ambulatory Award is given to independent Ambulatory practices which are on either Stage 6 or Stage 7, as depicted in Figure 1, achieved preset milestones and have achieved sustainable improvement outcomes through implementation of Health IT. The advantage of this award are that the applicant has to be do self-assessment which makes it understand its business better, get best practice guidance on leveraging health IT, opens more funding opportunities and wide-spread publicity of the success. The National Ambulatory Medical Care Survey (2012) reported that 72% of office-based respondents had an EHR, compared to 48% reported in 2009. The percentage varied from a low of 54% to a high of 89% by state. There are a set of criteria and five steps that an applicant has to follow to get his application in.
Fremont Family Care has four full time family practice physicians, a physician assistant, and one nurse practitioner with one family practitioner serving mostly geriatric population. There are two rural clinics attached to FFC which are in North Bend and Dodge Nebraska. Patients from these clinics frequently come to FFC for treatment. These patient information was stored in a paper chart at the facility and this posed a problem. FFC could not access the records unless the rural clinics were open and was becoming more burdensome as we were not able to track quality patient care, set goals for our practice, or effectively monitor patients. In October of 2010 FFC implemented EMR to address these issues.
FCP Goals. There were a pain points that FCP wanted to address. FCP staffed rural clinics in North Bend and Dodge Nebraska along with that in Fremont. The people in those areas, sometimes, visited FCP if the rural clinics were closed or the doctors were not available. At times these patient’s records were not available for the Physicians at FCP unless the rural clinics were open.
FCP realized that their then current technology supported only reactive healthcare. Their goal was to increase the percentage of patients who had age appropriate screening tests for mammogram, colonoscopy and pneumonia vaccine. The current method of tracking patient’s follow-ups using paper charts was difficult, tedious, error prone, and unreliable.
FCP went live with EMR in October 2010. With this, the providers had access to patients’ past records and all tests were ordered via the EMR following go live. The Clinical Decision Support System allowed providers and staff to monitor patients so that they are alerted to if any patient is due for an age appropriate screening tests. The clinical were able to order mammograms, colonoscopies and pneumonia vaccines if the CDSS systems alerted them to the need. The registry feature was used to create lists of patients due for cancer screening and send letters to ask them for initiating appointments. Patients were reminded to go for HbgA1c and track patients who had a HbgA1c above 7.
Outcomes. FCP started achieving positive outcomes including; (1) reduction in pneumonia related readmissions, (2) better preventative care for at-risk patients, and (3) increase in the number of diabetic patients whose HbGA1c was under control. The percentage of patients who had colonoscopy increased from 37% in 2011 to 70% in 2014. It also increased the percentage of patients with HbgA1c less than 7% from 26% in Q1 2013 to 45% in Q2 2014. The percentage of patients who received pneumonia vaccine rose from 56% in 2011 to 75% in 2014 with a corresponding rise in revenue from $243 in Q1 2011 to $21,923.61 in Q1 2014. Screening mammograms rose from 20% in Q4 2010 to 56% in Q2 2014. There was about $6000 cost savings in Q3 2014 compared to Q1 2013. FCPs total investment was $137,000 and the total ROI by 2014 was $380,000 and increase in revenue was $114,000.

References

Annual Study. (2015, April 10). Retrieved from HIMSS Analytics: http://www.himssanalytics.org/data/annualStudy.aspx
Belmont, E. (2015, April 10). Fremont Family Care - Davies Ambulatory Award. Retrieved from http://www.himss.org/: http://www.himss.org/files/FileDownloads/Fremont%20Core%20Clinical%20Value%20final.pdf
Belmont, E. (2015, April 10). Fremont Family Care - Davies Ambulatory Award. Retrieved from HIMSS: http://www.himss.org/files/FileDownloads/Fremont%20Menu-Population%20Management%20final.pdf
Fremont Family Care Selected As 2014 HIMSS Ambulatory Davies Award Recipient. (2014, December 4). Retrieved from Health IT Outcomes: http://www.healthitoutcomes.com/doc/fremont-family-care-selected-as-himss-ambulatory-davies-award-recipient-0001
HIMSS Davies Awards. (2015, April 10). Retrieved from http://www.himss.org: http://www.himss.org/daviesaward
Hoyt, R. (2015, April 10). Benefits of switching to an electronic health record (EHR). Retrieved from Practicefusion: http://www.practicefusion.com/health-informatics-practical-guide-page-4/
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