Electronic Health Reporter

Improve healthcare for patients. A lofty goal for many clinics; perhaps easier said than done for most practices, but not all.

But with the tools now available to practices and physicians, some believe it’s only a matter of time until the entire healthcare landscape changes.

This drive for change is one of the reasons why practices are increasingly bringing electronic health records into their practices.

Sure, the EHRs help practices save money, space and supplies, such as paper, but for Adrienne Laverdure, medical director of the Lac du Flambeau Indian Health Center – the Peter Christensen Health Center – in Wisconsin, implementing an EHR wasn’t a matter of less paper or creating more space in the clinic; it was the obvious choice for improving the quality of healthcare for all of the practice’s patients.

However, Laverdure had little idea that implementing an EHR would lead to a 35 percent jump in revenue, longer life expectancies for the patient population and allow clinic to add more providers, which in turn, means more patients are now being served than ever before.

For her, all of these benefits were the surprising part of adding an EHR.

Community clinic meets community need

Located on the 400-square-mile Lac du Flambeau reservation in northern Wisconsin, the Peter Christensen Health Center provides approximately 16,000 patient visits annually. Until recently, the clinic served only Native Americans on the reservation, but now provides healthcare for employees and non-native patients.

Many of the members of this community and surrounding areas are medically underserved, said Michael Popp, director of information technology for the clinic, and the number of under or uninsured of people who are unable to afford the expense of paying out of pocket for a visit with the doctor or a trip to the emergency room continues to grow.

“We have a mission, and it’s to provide healthcare to all members of the community,” said Popp. “Care isn’t discriminatory, and we’ve found that when people don’t have proper coverage, they don’t know where to turn for healthcare. We’re in the position to help. We decided not providing care to everyone who needed it creates even more problems, so we opened to doors to everyone in the community that needs care.”

That decision meant the clinic went from being a Native American health center to a community health center, and for the patients that are under or uninsured, the clinic’s billing and finance specialists work to find them coverage, such as Medicaid.

To that end, the clinic recently moved from its 5,000-square-foot building into a newly built 26,000-square-foot facility. The clinic was able to accommodate more patients because of the practice management and enhanced patient care that was facilitated by the clinic’s EHR.

There was one problem with the move, though, said Popp. Architects blueprinted a chart room for paper records. A staple for most practices, the EHR changed that, he said, but the solution was simple: “We took that 400 square feet meant for the patient chart room created additional space for offices.  By shifting around office space, we had more room for providers to see patients.” said Popp.

Without the room dedicated to storing paper, additional patient visits were accommodated resulting in additional revenues. With increased revenue, tangible gains beyond that of the savings created from the lack of paper ordered by staff each week, began to pile up.

Improving patient healthcare outcomes

Peter Christensen Health Center is considered an early adopter of electronic records, having implemented its system more than five years ago. There isn’t a paper record in the clinic, said Popp, adding that clinic staff uses the EHR to streamline billing and claims processing, increase appointment setting and scheduling efficiency.

Streamlined billing means more cash, and with the EHR, most claims are paid within 14 days. Improved scheduling means there’s time for more patients, which means more people can be seen. Along with three M.D.s, an advanced practice nurse practitioner and a physicians assistant, the clinic provides podiatry, oral surgery, mental health and dentistry services. Each exam room has a computer with access to the EHR, which helps with patient education, Laverdure said.

“There are so many facets to how the EHR has been able to help us,” said Laverdure. “It has created so many efficiencies and it allows more time for our providers to spend time with our patients.”

The results don’t end there, she added.

Revenue increases aside, the EHR allows the clinic to track patient health data and providers can see health trends across the population. “We can see trends in the health of the people we’re seeing and we can really dig deep into the data,” she said. “With the data, we’re able to provide preventive care, and we’re much better equipped to handle state and federal reporting requirements.

“The EHR provides a phenomenal record for us to help us help our patients get the healthcare they need; I like to think that we’re improving each of our patient’s quality of life.”

Diabetes strikes much of the patient population in Lac du Flambeau, as well as other chronic conditions, but by using the EHR, physicians are able to track patient health outcomes, risk indicators and condition variations. This information better enables clinic staff help control and manage patient chronic conditions.

Because the patient’s care is now managed so thoroughly across the entire practice, Popp said the life expectancy of patients has actually increased by more than three-and-a-half years since the EHR was implemented.

Return on investment

The health center returned its EHR investment within six months, having paid it off in less than half a year, but the returns – far exceeding financial gains — keep coming, said Popp.

Other than saving supply costs, increasing revenues and improving patient care, the clinic has become a model of how an Indian health center can operate as a viable business.

During the last five years years, Peter Christensen has drawn the envy of other clinics, and at least two other Indian health centers are following suit and implementing an EHR similar to that of Peter Christensen.

“Other tribes have purchased their EHR based on what we’ve been able to accomplish,” Popp said.  “Perhaps we can be advocates for more than our patients, but for the healthcare system.”

But hurdles still remain, the biggest of which is often faced by Peter Christensen, like most clinics, is that it is underfunded, Laverdure said. But now there are ways to fix the healthcare system and control the practice’s costs, she added.

And that means something to the folks in northern Wisconsin, where until now healthcare seemed to have been rationed. “Now there’s money for preventive care. Now there’s money for care,” said Laverdure, “and we’ve been able to use the system to get out of that hole.”