Coastal Medical Realizes ROI with EHR Implementation

Medical practices across the nation are achieving success with Electronic Health Record (EHR) implementations! One example is Coastal Medical; a physician owned practice based in Providence, Rhode Island, a recipient of a 2012 Ambulatory HIMSS Davies Award of Excellence.

Coastal Medical has received significant benefit to their practice in three key areas:  financially, organizationally, and most importantly, by improving the quality of care they deliver to their patients. Overall, the practice achieved a 200% return on their investment in implementing an EHR.

Coastal Medical employs 91 healthcare providers, and delivers predominantly primary care services to 105,000 adult and pediatric patients.  That’s 10% of Rhode Island’s residents!  The practice wanted to do a better job documenting the care they provided patients, and a better job following up with patients to make sure they were returning to health.   Coastal Medical already had a reputation for providing good care; they wanted to do even better. So, they provided their staff with better IT tools to take the best possible care of patients.

And, an EHR was the right tool for Coastal Medical. In 2006 and early 2007, Coastal implemented a fully integrated EHR in each of its 19 offices. This implementation meant Coastal could now actually measure the quality of the care being provided to patients, and to report it.  Coastal Medical participates in the Medicare Shared Savings ACO program and Patient-Centered Medical Home (PCMH) practice transformation.

As a result of their EHR implementation, the care providers at Coastal Medical got to spend more time with patients, and patients experienced a smoother experience when they needed to see a clinician.  Another benefit for patients was that – thanks to the EHR – Coastal Medical expanded its office and Saturday hours.  Now, patients can come to see a clinician on the weekend, eliminating a potentially long wait in an Emergency Room because no clinic is available.

Coinciding with completion of the EHR adoption in early 2007, Coastal Medical entered into its first pay-for-performance contract with Blue Cross Blue Shield of Rhode Island (BCBSRI). This contract helps the practice grow its business as BCBSRI makes additional payments to Coastal Medical for providing better care to patients.

We at HIMSS encourage all practices to measure their performance and the quality of care they provide to their patients. At some point in our lives we all will be patients and we deserve the best care possible.

As a clinician or as a patient, how has an EHR improved patient care for you?

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2 Responses to Coastal Medical Realizes ROI with EHR Implementation

  1. Has the 200% ROI translated into measurable, i.e., better outcomes, improvements in quality of care, significant enhancements to continuity of care and reduced cost to the patient, i.e., reduced premiums, and has interoperability between and among all care givers, in the community, provided a successful transition of care experience for the patient.;

  2. Thanks for asking. Yes, yes, and yes. We are better able to manage our chronic patients using the emr (eClinicalWorks). For instance, at any point our physicians can look up all of their uncontrolled diabetic patients A1C’s and know which patients we need to reach out to – that is the key really – we are able to reach out to patients (pro-active care) rather than wait for them to become sick enough to call, or become hospitalized. As you can imagine, if we are able to prevent patients from getting sicker and being admitted, we are improving their health and quality of life – as well as reducing the overall cost of their care. About reduced premiums – interestingly, employers are starting to understand the PCMH model of care. We currently have two relationships with employers where their employees pay a reduced insurance premium if they choose to see a Coastal Medical PCP.

    Interoperability has been one of the most exciting results for our group. In 2010, because of our emr, we opened a weekend Clinic for our patients to have access to sick visits. We currently serve 105,000 patient in 20 different medical offices, having the single emr where all records are available to our physicians made it possible for any physician to work the clinic and fully understand the needs of each patient – their record was immediately available. The clinic has reduced our ER visits by 27% and in 2012, the clinic became “Coastal 365” and now offers sick visits every day of the year, including holidays. We are also connected electronically with our local hospitals, more information about the patient in an emergency can only be a good thing, though I don’t have specific statistics to report on the hospital/emr connection at this time.

    Without going too long here, with the emr we were able to take advantage of numerous pay for quality initiatives such as Meaningful Use, PQRI, E-prescribing…we have also been able to achieve NCQA Level 3 recognition for all of our practice locations. We don’t think for a moment that meeting all of the quality measures required does not positively impact patient care or experience, we are seeing the good results.

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