Dr. Craig Summers’ relationship with Yale New Haven Hospital began when he was a pediatric resident. Since founding his own practice, Children’s Medical Group, in 1981, he has maintained a close working relationship with the hospital, where many of his patients are born, operated on, and referred to for specialist treatment. For more than three decades, Dr. Summers sustained this key relationship through phone calls, faxes, and most often, letters.
Easier Access Brings Greater Insight into Patient Care
None of these communications were in real time, and coordinating patients’ care outside of his practice in this way made it difficult for Dr. Summers to follow up on their outcomes. “If it wasn’t an acute problem, it could disappear off my radar until I got a letter back [from the specialist],” Dr. Summers said. Finally, in 2014, Dr. Summers partnered with athenahealth to get his practice off paper and onto an EMR and revenue cycle management system.
Dr. Summers said he chose athenahealth for “its network design on the cloud, the flexible platform that offered us all upgrades without hidden costs, and support for the requirements we expected to be faced with to qualify for Meaningful Use and patient-centered medical home programs.” But in the meantime, Yale New Haven was already using Epic for its electronic health records (EHR), so one of the first challenges athenahealth partnered with Children’s Medical Group to resolve was establishing a connection between the two systems.
Children’s Medical Group worked with athenahealth’s dedicated interoperability team and the IT team at Yale New Haven, and now his practice can access a single view of the patient chart to track care across both settings.
When a baby is born at Yale New Haven Hospital, a new patient record is created in athenaNet, and providers at Children’s Medical Group can access it immediately from their practice in Hamden. By the time the patient comes in, they can see the care the baby has already received and also pull information from siblings’ charts to generate the medical and social history for the new patient. It’s the first step in establishing a longitudinal view of the patient that “paints the picture that I would always want to see when taking care of one of my patients,” said Dr. Summers.
Over time, this easy access to a single view of the patient helps Children’s Medical Group provide more attentive care. “When someone calls or comes in and I open up that chart, I can navigate to the issue more effectively and see what’s transpired around the event and illness,” Dr. Summers said. In addition to decreasing the distractions he faces while seeing patients, this also helps Dr. Summers more easily make efficient, cost-effective care decisions—a key factor in helping his practice adapt to value-based care. “The immediate ROI was being able to see the picture of the patient almost at any time or any place. Whether I was at home or I was away or on my phone or at the office, I had a better picture of the patient.”
Smart Curation of Patient Data Minimizes Extra Work
Simply receiving more patient data, though, wasn’t the final solution for Children’s Medical Group. Across the industry, information overload has been a common side effect of increased interoperability. A recent study found that primary-care physicians receive 77 notifications a day, on average. Only 20 percent of those were test results.2
Dr. Summers had seen this for years in his correspondence with specialists: “They tend to provide me reams of information, when there’s probably a paragraph I’m interested in.” To help him hone in on the information he needed most, athenahealth worked with Dr. Summers to create the “Outside Visit Summary,” which organizes documents shared by other providers his patients see. We also created rules to automatically file unnecessary documents within athenaNet, so the only notifications Dr. Summers receives in his inbox are admissions summaries, discharge summaries, and emergency department notes. If he wants to view additional information, Dr. Summers can open these auto-filed documents, but they won’t distract his attention from what’s most important.
Both of these capabilities are still in the alpha phase, but the features and functionality developed for Children’s Medical Group will inform future chart-sharing capabilities developed for the entire athenahealth network.
During a period just over two weeks long, the athenahealth team helped Children’s Medical Group reduce the number of documents to be worked for newborn patients by 88 percent by automatically creating newborn charts so related documents could be properly identified and labeled. Now athenaNet automatically labels 70 percent of the documentation the practice receives.
Maintaining Clinical Relationships—and Organizational Independence
For a small practice such as Children’s Medical Group, an efficient approach to interoperability can help reduce administrative work, improve the quality of care, and ultimately thrive as an independent practice at a time when health systems encourage their affiliates to work within one system. Partnering with athenahealth, Dr. Summers said, “provides me the flexibility of maintaining my independence and yet still being tied directly to the institution that I care about, that I need, and that I use—much more effectively than previously.”
This partnership not only drives positive results for Children’s Medical Group, but also for the healthcare system as a whole. Easy access to a complete view of the patient’s medical history helps Dr. Summers avoid ordering duplicate or redundant testing. In the long-term, he said, “It’s going to pay dividends, because I’m going to direct patients’ care more efficiently without redundant testing and save the system money as well.”