On a Solo Ride to PCMH

“The EHR allows us to pay better attention to the data we have. Using regular registry queries, I can tell which of our patients are overdue for a service related to chronic disease management and preventive care…and it becomes actionable right then and there,” Rippel says. “It’s not just using the EHR as a data repository. It’s using it as a data repository with actionable events.”

Rippel, like many others in his field, is still figuring out why some patients use the secure, online access to their EHR, and some do not. He says those who use his portal, love it. It allows him to get back to them in a timely fashion, much quicker than the phone that requires simultaneous availability. Also, if he doesn’t have all the data on something, he can further research it and provide a reference for the patient.

A Patient-Centered Neighborhood

In two short years, Rippel made back his entire investment in EHR training, software, and hardware – a number he puts at approximately $50 thousand. “I wish all my investments had an ROI like this,” he says bluntly.

The majority of the compensation, Rippel notes, didn’t come from government incentives, but rather through the costs saved from no longer having to outsource billing because it was integrated in the EHR and through pay-for-performance from commercial payers. “These insurers are saying data is power, and they are willing to pay for it,” he says.

All this is to say that Rippel says the investment is worth it, even for smaller or solo practitioners like him, who have less to spend than a major hospital system or integrated provider. “An investment and improvement of primary care now is extremely modest compared to the benefits on the back end that the patients and the healthcare system will gain from and enjoy be able to enjoy from the perspective of health and the perspective of cost,” he says. 

As for Rippel himself, he recognizes that his own road in the overall transformation of healthcare is “only a third of the way along.” However, he is skeptical about a pure pay-for-performance model for solo practitioners, saying the lack of resources do not justify the additional costs.

As a result, he is working with a group of colleagues to start a multispecialty group in his community that will be physician owned and operated. His goal is to implement a single, community-wide EHR solution that brings as many primary care providers, and engages sub-specialists, within a reasonable timeframe, to be involved with elements of a patient-centered neighborhood.

“The essence of the multispecialty group is that everyone who participates shares a fundamental belief that it’s in a patients; best interest and the interest of the healthcare system for physicians to coordinate their healthcare, while controlling costs and improving quality,” Rippel says.