Inland Empire Foundation for Medical Care (IEFMC) and Manifest MedEx are bringing health care into the digital age. The network of more than 60 small medical practices is modernizing its offices in the greater L.A. area by joining the health information exchange to enhance patient care and help make it more affordable.
The benefits for patients and their doctors – even for small, independent medical practices – are significant when providers join forces to be part of a secure health information exchange utility.
Dolores Green, CEO of the foundation and Manifest MedEx board member, sat down with us to share more about the innovative work supporting these small, independent practices in Riverside and San Bernardino counties:
How is Inland Empire Foundation for Medical Care (IEFMC) helping small medical practices stay on the cutting edge with help from Manifest MedEx?
Each morning IEFMC receives daily action lists from Manifest MedEx. These lists identify patients of each practice that have been seen in the emergency room, been admitted to the hospital or have been discharged. We then contact the doctor’s office first thing in the morning and notify them that they had a patient, for example, discharged from the hospital the previous day. This allows them to contact the patient to check to make sure they are settled at home, have filled their prescriptions, or if they have additional questions or need assistance with their discharge orders. They will also schedule an appointment for the patient to be seen within seven days of discharge. By doing this, we’ve seen significant reductions in emergency room visits and re-admissions to the hospital.
If you're hospitalized, what will your doctor know? How does Manifest MedEx help patients when they are leaving the hospital and recovering?
With Manifest MedEx, the primary care physician (PCP) receives an alert when their patient is hospitalized. The PCP can then contact the “hospitalist,” a physician at the hospital who will care for the patient during their hospitalization and provide additional insight and discuss their patient’s needs and circumstances. When the patient is discharged from the hospital their PCP receives an alert which allows them to follow up with their patient to answer any questions they may have and ensure their health needs are being met.
Being in the hospital is scary for most patients and going home alone, or with family members who are uncertain of what to do causes great stress. Now when their doctor is notified that the patient is discharged and able to call the patient and check on them, answer questions and/or provide reassurance to them – that is a “lifeline” greatly appreciated by the patient.
How can these kinds of health information exchange (HIE) programs help to make healthcare more affordable?
Having important patient information, no matter where that patient receives their care, helps the physician or healthcare team provide better care to the patient. For example, a patient goes to an emergency room where they’ve never received care and are unable to communicate their medical history or, can’t remember what medications and dosage of the medication they are on, or maybe had an MRI or other expensive test done elsewhere in the recent past. By accessing the HIE, the doctor can see the patient’s health history and rather than repeating tests, can address the health concern more immediately. The same is true if the patient is hospitalized. The hospital care team can develop a plan of care immediately rather than having to wait for additional information.
Even more significant is the notification upon discharge and making sure that the patient is seen by their doctor within seven days. By doing this, we have been able to reduce our inpatient hospital stays; lower hospital readmission rates (almost half the rate for patients seen within seven days post-discharge compared to those who were not); and emergency department visits have decreased which have resulted in a significant reduction in health care costs for the patients we care for.
What other new uses of health data are you excited about in your community?
Having access to health data is exciting on many fronts. We have an active Palliative Care Coalition in the Inland Empire that works with patients to ensure they have a completed health care directive as well as for some patients a POLST form (Physicians Order for Life Sustaining Treatment). Our goal is to ensure this information is available through the HIE so no matter where the patient seeks care, the health care team is able to know the patients’ wishes for their medical treatment. Also, as healthcare is shifting to value-based care, focusing on population health and whole person care projects, having health data is vital to the success of these programs.
Why are small medical practices so important for communities?
Small practices have been the backbone of providing care for patients for years, especially in rural communities throughout California. Unfortunately, they often struggle to stay current with technology that can better improve their office workflows and ensure patients are getting the right care at the right time. That’s why it is important that we find ways to support physicians in whatever mode of practice they choose to ensure access to care for all patients and allow them their choice of doctors.