Health IT, Hospitals

Small primary care practices can thrive with EHRs, ingenuity

With a little ingenuity, small primary care practices can improve and offer a competitive advantage to the likes of national retail clinics.

it’s possible for small medical groups to thrive in the current environment. It just takes a little ingenuity and some properly implemented technology.

Two weeks ago, I called CVS Health’s MinuteClinic a “nice adjunct to primary care.” Sometimes, though, there’s nothing like the original, especially when the original is doing its best to improve care and service.

I caught a bug over the long weekend and couldn’t shake it with over-the-counter cold medicine, so I got up Wednesday and went to my internist’s office. Without an appointment.

Yes, this six-physician primary care practice sets aside the first 45 minutes each weekday morning for walk-in visits by established patients. It’s a competitive move meant to address loss of business to convenience care like MinuteClinic, and it’s really a strategy more small physician practices should adopt if they wish to remain independent in this era of consolidation.

The practice also has a concierge option for a small number of patients willing to pay an annual fee. I am not among them, but it’s another way to stay competitive.

As for the visit, I arrived about 8:30 am, half an hour into the 45-minute walk-in window. There was minimal paperwork to fill out, just a notice and acknowledgement of the practice’s new policy of keeping a credit/debit card on file for all patients in order to cut down on people abandoning small invoices for copays and such. That’s another smart move.

Amazingly, I did not have to update my medical history on a clipboard, because the practice has had an EHR and functional patient portal for years, another rarity among small medical groups.

Also amazingly, when I got into the exam room, the nurse did not have to key my weight into the computer because the scale automatically sends readings to the EHR. That’s right, there’s EHR connectivity with medical devices.

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The doctor on call that morning — not my regular internist, but one of his partners  — didn’t keep me waiting more than about two minutes after the nurse finished vitals and noted my chief complaint. She ordered a flu test, which thankfully came back negative, told me based on my breathing that I didn’t have bronchitis or strep throat, and diagnosed me with a upper respiratory viral infection, otherwise known as a bad cold.

I was sent home with a prescription for a narcotic cough medicine that I only was supposed to fill if I didn’t get any better, as well as a printed clinical summary of my visit. That’s right, the small practice gave me a printed clinical summary without me even having to ask. The same report appears in the patient portal, which I could download to a personal health record if I were so inclined.

I paid my insurance copayment and was out the door by 9:20 a.m., just 50 minutes after I arrived. A little more than a day later, I feel much better, and I haven’t even needed to get the codeine.

This small practice is efficient, convenient and, oh, by the way, qualified for Meaningful Use Stage 2 in 2014 and is on track to do so this year, thus avoiding Medicare penalties that so many providers have complained about.

Yes, it’s possible to meet Stage 2. It’s possible to provide great customer service while, presumably, meeting quality standards (I have no way of knowing just yet that the diagnosis was accurate, though I’m pretty sure the doctor was right not to prescribe me an antibiotic.) And it’s possible for small medical groups to thrive in the current environment. It just takes a little ingenuity and some properly implemented technology.

Photo: Flickr user Army Medicine