Taking the “work” out of workflows


SIHF Healthcare | Belleville, IL

  • capitol-purple-tape

    Federally qualified health center

  • Purple medical bag stethoscope and syringe

    Offers medical and dental care

  • globe purple location icon

    30 locations across Southern Illinois

  • Girl and boy pediatric patients

    Runs family medicine residency program

  • Female physician purple hair

    179 providers

  • Male and female patients

    1,100+ patients seen each day

Issues

  • Providers unhappy with cumbersome EHR workflows
  • Difficult to access patient information outside the health center
  • Unable to take on quality reporting due to slow technology
  • Lack of direct customer support from vendor

Results

  • More efficient documentation 7.39 minutes per average encounter
  • 79% same-day encounter close rate, above average among FQHCs on athenahealth
  • Able to use campaigns to close care gaps and generate UDS reports monthly
  • Single point of contact at athenahealth to monitor performance

There was a time when technology was something to be circumvented at SIHF Healthcare. “You would just lose papers to what I called ‘Scan Land,’” Anne Nash, MD, said of the delays between receiving faxes and getting them digitized and filed within the health center’s EHR. “If something was really important, you didn’t want to scan it in. You wanted to keep a copy of it so that you knew you would have it if the patient was coming in.”

SIHF Healthcare’s previous EHR vendor wasn’t working out for providers at the federally qualified health center (FQHC). The health center didn’t even complete implementation across all its locations – six sites were still charting on paper when they finally made the switch to athenahealth. Using athenahealth’s EHR has been a very different experience. “It’s fast, and it’s easy to read and easy to follow,” said Nash, SIHF Healthcare’s quality assurance medical director and associate program director of family medicine residency program.

With athenahealth’s healthcare technology, including electronic health record, revenue cycle management, and patient engagement services, SIHF Healthcare can rely on technology that helps fulfill its mission of providing adult and family medicine, pediatric, OB/GYN, behavioral health, and dental services to underserved communities across Southern Illinois.

Spend less time in the EHR and more with patients

An EHR system is only as valuable as the information it contains, so it wasn’t a good sign when the health center’s obstetricians balked at using its previous EHR. “I think it was just too cumbersome, and it took so much time to get their details entered,” said Nash. Obstetricians preferred to enter patient data in the American College of Obstetricians and Gynecologists (ACOG) form, something they can now do directly in athenahealth’s EHR.

Nash made sure providers across all specialties were aware of the efficiencies they could gain by documenting in their new EHR from the very beginning. The health center required providers to take advantage of athenahealth’s one-on-one coaching sessions to help them make the most of athenahealth’s clinical workflows. Nash also works demos of new functionality into in-person meetings with providers. Now, providers spend an average of 7.39 minutes documenting an encounter, and 79% of providers close out their documentation on the same day of the visit.

And there are numerous ways in which Nash and her colleagues have been able to streamline their documentation. Text macros allow her to save her most frequently used order sets, notes, and other actions. It’s more efficient for her to prescribe, too. On her previous EHR, she had to review and approve each medicine her nurse had already prescribed. “Now, I get a list of all the orders that people have done for me throughout the day, and in one click I can sign off on all of them,” said Nash.

Gone are the days of losing test results to “scan land” – with athenahealth taking over the health center’s fax, any results are automatically digitized and attached to the appropriate patient chart, so when Nash looks up a patient, she can trust the information she needs will be there. “Everything is much faster – the way we get documents, the less staff we have to use to sort and scan documents, and the one-click sign-off for all of the orders for the day that lets you delegate to staff,” she said.

Coordinate care from anywhere

As a health center that provides primary care and supports a residency program, it’s important for SIHF Healthcare to be able to coordinate across care teams and settings. One way physicians collaborate with residents is through athenaText, a mobile app that sends secure, HIPAA-compliant messages. “If there’s something they notice or even if my patient came into the hospital last night, residents can send me a text,” said Nash.

Nash also uses her mobile phone to access her patients’ athenahealth records when she’s not at the health center. “I can work from anywhere,” Nash said. “I can look stuff up on my phone or iPad. Sometimes I get work done in the car at soccer practice. It’s a lot more mobile.” When she’s practicing out of the local hospital, which uses Epic’s EHR, she can pull results up on her phone to show patients instead of logging out of Epic on the computer. And when she’s back at the health center, she can receive test results from the hospital via an interface so that they appear directly in her patients’ athenahealth charts. If her patients go to the hospital for a mammogram, for example, “I may get the result while they’re still driving home,” Nash said.

Get better view into quality management and reporting

Before athenahealth, SIHF Healthcare wasn’t doing any reporting on quality management. “We didn’t have enough bandwidth to run the reports for an organization of our size. You’d have to wait until five o’clock to run any report, and it would take forever,” said Nash. Now, she runs UDS reports each month to share across the organization so providers can see how they’re performing compared with others in their specialty. “With athena reporting, it’s no problem to just run it in a few minutes during the day,” Nash noted.

The ability to view data across the health center’s patient population also helps Nash and her team improve quality outcomes by determining which patients are in need of care and configuring outreach campaigns to help close those gaps. For example, each week Nash runs a report to identify unfilled lab orders. Patients receive a phone call reminding them to go to the lab or asking them to report the results if they already received them. Nash can then review a report of patients who received phone calls and the outcomes of those calls.

When it comes to documenting quality measures, Nash has full visibility into how her health center is performing, and individual providers can also track their own performance on the measures in which they’re enrolled throughout the year. On other systems, Nash said, she’s received high-level “stop light” reports that rate performance with red, yellow, or green categories. “But I don’t have any idea where the metrics come from or where I wasn’t doing well, or which patients I didn’t get credit for. I like that athena lets you see exactly where the data is coming from,” she said.

A dedicated partner provides support

While SIHF Healthcare’s experience with athenahealth has been much smoother, one benefit to the partnership is that the health center has a dedicated customer success manager to provide support when it is needed. With their previous vendor, the health center had to report any issues through a third-party organization.

Now, it’s much faster for Nash to call athenahealth’s Client Support Center when she hits a snag. “Getting help for the minor issues is easy – you call in, or you email your case, and it’s pretty quickly handled.” For anything more complex, she can work with her customer success manager. “Then you have someone that can raise an issue quickly and help connect you to the right person.”

But most of the time, Nash isn’t running into any major issues with athenahealth’s healthcare technology. On the contrary, she said, “We are succeeding using athenahealth because we invested upfront time into clinical configuration, earned provider buy-in and engagement, and have improved connectivity. athena has truly demonstrated their commitment to continuous improvement and letting doctors be doctors.”

Everything is much faster – the way we get documents, the less staff we have to use to sort and scan documents, and the one-click sign-off for all of the orders for the day that lets you delegate to staff.

— Anne Nash, MD, SIHF Healthcare