From Solo Family Physician to a Patient-Centered Medical Home
Robert L. Smith, MD, MSFinger Lakes Family Care
Canandaigua, NY
https://www.fingerlakesfamilycare.comhttp://www.robertsmithmd.com
Redundant and inefficient processes Paper charting Inability to search your patient population Increased wait times Staff and patient frustration Dictation delays
My Workflow Before Becoming a Medical Home
1. Solo practice percentage: 1986, 44%. 2008, 18%.2. All-inclusive nature of the Marcus Welby, MD character is
personified by the Medical Home practice model.3. Solo practice physicians can have a modern lifestyle in
the day and age of hospitalist and team based care.4. Personalized care is the foundation of primary care.5. Implementation of EMR systems can be done affordably.6. Availability and access to care is paramount to overall
cost saving within health systems.
Dispelling the myth of the solo physician
Making “The Leap Of Faith” from the traditional office to a Patient-Centered
Medical Home
Feb 2006, Finger Lakes Family Care founded using Amazing Charts as the electronic medical record and Updox for document management. (0 patients and a 1500 sq ft office)
March 2006, 1st Nurse Practitioner joins practice. July 2009, Invited to become a charter practice of
the Rochester Medical Home Initiative. September 2009, 2nd Nurse Practitioner joins
practice.
Our Journey to a Level 3 Medical Home
May 2010, Migrated to our state-of-the-art offices in Canandaigua. (4000 patients and a 3400 sq ft office)
June 2010, Received Level I PCMH-NCQA certification. Nov 2010, Received Level III PCMH-NCQA
certification. 2011 and beyond: Virtual Visits, Patient Portal, Group
Visits, etc.
Our Journey Continued …
1 full-time MD and 2 part-time FNPs 2 providers daily working as a team 2 LPNs 1 RN Care Manager 1 Clinical Assistant 3 Clerical Associates Provider to staff ratio: 1:3.5
Our Practice Model
Efficient charting and clerical tasks Charts are available to multiple people
simultaneously Open Access Scheduling and “Quick Sick” Visits Increased staff and patient satisfaction Improved efficiency = increased revenues
Examples of EHR, Population Based Management, Patient Portal, Virtual Care, and Social Media to follow.
Our New Medical Home Workflow
NCQA PCMH Certification
Improving quality of care by organizing care around patients
Coordinating care and managing information Early evidence suggests that PCMH improves
quality and returns savings Level 1: 35–59 points and all 6 must-pass elements Level 2: 60–84 points and all 6 must-pass elements Level 3: 85–100 points and all 6 must-pass
elements
Our Practice’s Technology
Population Based Data Analysis
EHR Reporting
Social Media
Virtual Care is telemedicine in the real world! Affordable by patients and small offices! Generic: webcam and internet connection
only! Enhances communication and access! Examples:
Home care nurse in a patient’s home Remote family members brought into an ICU
consult Maternity patient meeting with family
members
Virtual Care Servicesby NowDox
Creation of a Patient-Centered Medical Community
Increased proportion of virtual care visits Increased online services via our Patient Portal Increased revenue directly from patients Hybrid Concierge Model
Being available to patients whenever they want and how you want to be notified!
Next Steps