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Native American Clinic Provides Proactive Healthcare

September 22, 2010
by John DeGaspari
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A rural clinic employed EHR to improve healthcare to its Native American population and expand its services to the surrounding community

The Peter Christiansen Clinic, which is part of the Lac du Flambeau Reservation in northern Wisconsin, has seen tangible benefits in improved healthcare to its patients as well as significant cost savings since going live with electronic health records five years ago.

The clinic, which has been in existence since the 1960s, is the largest employer in Vilas County, serving a Native American population of 3,000, in addition to about 1,000 tribal employees. Michael Popp, who is the clinic’s IT manager, clinical coordinator, and HIPAA officer, says the clinic brought in an electronic health record (EHR) system for clinical and business reasons. “There were two pieces of our business that were lacking,” he says. “Like every other group out there with paper charts, we were always chasing charts. We kept hiring more and more people to move more and more charts. It was endless.”

To address those challenges, the clinic brought in Intergy EHR, supplied by Sage Healthcare Division, Tampa, Fla., as the core of the clinic's electronic medical records system, says Popp (who is a former Sage employee). It is interfaced with other modules serving the clinic’s various services that are physically located in separate buildings, including dental, pharmacy, and laboratory. “The communication between people regarding a patient is much more effective,” Popp says.

Popp says that EHR provides strong case management capability, allowing the clinic to keep track of health alerts. This is important for serving the Native American population, for whom diabetes is the No. 1 diagnosis. “We keep close tabs on our diabetic patients,” says Popp. He adds that the clinic has been able to customize the software to make it easier to monitor for pre-diabetic conditions in children and other health risks, he says. Once a patient is diagnosed with diabetes, a case management file is created for the patient’s name, beginning an educational process where the patient is taught good dietary habits how to monitor blood sugar levels; and appointments are set up with an optometrist and podiatrist.

Popp maintains that the clinic has, with a few exceptions, eliminated paper records. “We have workflows that have paper here and there, but the majority of everything we do is paperless. It saves people a lot of time running around chasing paper and chasing charts,” he says. EHR has allowed the clinic’s physicians to “better monitor patients, provide better patient care, provide better patient education, and make an overall impact to make our patients healthier.”

On the business side, Popp says the clinic has gained better control over its insurance billing and accounts receivables. He adds that the EHR automatically codes visits for the doctors, which has increased the clinic’s insurance reimbursements.

Popp maintains that improvements in the clinical and business side have allowed the clinic to be more proactive with patients. “We have five years worth of data on our billing site,” he says. "We are able to run reports and trend it now." This allows the clinic to spot potential problems early and take preventative measures, he says.

Having better control over its finances has allowed the clinic to make informed decisions on contracting with outside providers for certain health services. Last year, for example, the clinic contracted with an outside provider that sends a van to the clinic twice a month for provide mobile radiology services. “It saves us a big chunk of money every time the van pulls in; it’s at a much lower cost than sending [the patient] to a hospital downstate, because we are in a rural area,” Popp says. The clinic has also contracted to providers in the surrounding area for physical therapy and occupational therapy services at a lower cost than providing the services in-house, he adds.

In April the clinic opened its services to the general public. To eliminate access issues with its Native American population, the clinic has imposed some limits on how many new patients are admitted. “We have not had issues so far," Popp says. He adds that in the case of the clinic, the use of electronic medical records “has paid for itself.”