Located in a medically underserved area of rural north-central Wisconsin, Peter Christensen Health Center shows how the successful transition to an electronic health record (EHR) can fully support improved performance for patients.
Located in a medically underserved area of rural north-central Wisconsin, Peter Christensen Health Center shows how the successful transition to an electronic health record (EHR) can fully support improved performance for patients.
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Founded in 1960 as a Health Center for the Lac de Flambeau Chippewa Indian Tribe, The Center became a Federally Qualified Health Center (FQHC) in 2010, opening its doors to the community at large. As the Center worked to collect information for proper FQHC billing, it soon realized that its old billing system was inadequate to serve its needs. Drawing patients from throughout the area meant serving more under-insured and uninsured patients, in addition to a mix of Medicare and Medicaid patients.
In a modern building that houses a family practice, urgent care, pharmacy, imaging center, lab, and staff areas, the clinic’s three physicians handle about 25,000 patient visits annually. Supplementing them are clinicians who provide podiatry, oral surgery, mental and behavioral health, physical therapy nutrition, community health and dental services.
In leading this change, the Center’s leaders understood that along with FQHC status, there would have to be a transformation in managing clinical information. Peter Christensen Health Center jumped in with both feet by simultaneously implementing the practice management system and the electronic health record, Sage Intergy. In addition to the remarkable financial results – the return on the EHR investment paid for the system in just six months – there were substantial improvements in efficiency and patient care.
The EHR saves an estimated five to 10 minutes per patient in chart prepping, particularly for patients with chronic illnesses. The time saved in just this one task has allowed the Center to make better use of staff time.
Diabetes is the number one diagnosis for mortality and complications for the Native Americans, who remain the vast majority of the clinic’s patient population as well as many of its newer patients. Faced with those needs, the Center required an EHR that enabled proactive management of patients.
Hope Williams, one of the Center’s certified diabetic educators, stated: “It really allows you to help patients manage their diabetes.”
“We believe that the patient is the lead in the management of their diabetes. We are able to update this [Health Tab] tool and then print it for them so they can understand what needs to be done to take best care of their diabetes,” she says.
From a patient safety perspective, the Sage Intergy EHR has proven invaluable. In the past, patients who came to the clinic for “urgent” visits might call in a few days later for a medication renewal – and receive it without anyone conducting a thorough medical review. As a result, no one was proactively managing the patient’s chronic illness.
Nurse practitioner Dana Irmick sees a world of difference now with the EHR’s ability to track patients over time. For example, she and the other providers can quickly enter height, weight and other clinical data into the EHR during the many well child visits they handle each month. Irmick can easily call the information up electronically to review and share with parents.
Irmick also values the EHR as an aid in helping her to raise patients’ awareness of their own health progress, or lack of it. Turning the EHR monitor toward the patient during an exam, she can show patients a display of their labs and health data over time. A patient with hypertension might claim that her blood pressure was high “just today,” but a screen display of BP results over time can provide the visual evidence needed to get that patient’s attention.
“It gives patients more ownership by seeing their labs and health data across a time period,” Irmick says.
Providers and nurses use the EHR to quickly spot diabetic patients who have not had follow up visits in the past six months. They can then submit those orders as well as schedule the patient for an appointment with a physician if needed – all electronically.
Physicians can instantly initiate orders for podiatry, optometry, and other interventions during the encounter with the patient. The EHR allows the Center to truly work as a team. The providers use the EHR during encounters, but the incredible impact has been on population management. The Center constantly mines data from patients who haven’t been seen in accordance with the interventions recommended by their physicians – in addition to visits that are overdue, patient records are queried routinely for tests that are outstanding.
Today, Peter Christensen Health Center is truly a medical home for the 25,000 patients it serves each year. It presents a shining example of the integrated and responsive approach to health care, and it does so while meeting the financial and clinical challenges of serving a rural and disadvantaged patient population.
