Saturday, May 28, 2011

Progress Note

It has been a busy few weeks, accelerating Green Spring Internal Medicine down the runway and into the air, as we rise up to the challenge of Patient-Centered Medical Home transformation.  I have been to a series of conferences and webinars and am even presenting a webinar for CRISP on electronic medical records (EMR) implementation in small practices.  I am excited to be in a role of championing the cause of EMR, having been a trailblazer all these years and continuing to blaze ahead.  An article published online and in print this week, in the newly minted Maryland Physician Magazine, features our practice.

I just finished writing and submitting an op-ed article to the New York Times on healthcare driving forces, so keep your eyes out!  If I am rejected, I think I will recover.  After all, I am not a full-time writer.  Still, I do have a heart to translate the high-stakes issues to common folk so that we can all better understand and push for what is good in healthcare delivery.

I have been working long hours, smoothing out some of the wrinkles of our eClinicalWorks Version 9 upgrade.  Having set our system up in 2006, there are many features we still need to customize in order to maximize the use of the software and to prove to Medicare that we have achieved its "Meaningful Use."  One of the greatest new features is the upgraded Patient Portal.  We will soon be able to offer online scheduling and pre-registration for our patients.  Already, patients are able to go to our Portal to see their lab results when they have gone to Labcorp.  The same will soon be true of Quest lab results.  We have also been reaching out to Johns Hopkins and Sinai Hospitals to put together interfaces and to streamline communication between our entities when patients are admitted.  Through CRISP, we will soon have the ability to have radiology results arrive in our patients' records as soon as they are available.  This degree of efficiency is of life-saving magnitude.

By far, the best news of all is that Amy Luebehusen (pronounced loo-bee-hoo-sen), CRNP, has agreed to join our practice in June.  Amy is a Marylander and did nursing school and training at University of Pennsylvania.  She has extensive experience in clinical practice and chronic disease management.  Most importantly, her heart is in the right place about primary care and building longterm relationships with patients.  She will come on board partly in the capacity of our Care Manager, a role defined within the Joint Principles of the Patient-Centered Medical Home.  She will also serve in the capacity of primary care provider and will be filling in for me at the end of June during my vacation.  Her official start is at the beginning of July.  She and I will share more complex patients, and she will also establish a panel of her own patients.  Though certified nurse practitioners and physicians have different root training, our skill sets are complementary.  For example, Amy also has a lot of experience in women's health including gynecology, which has never been my forte.  CRNP's bring a lot to the table in primary care, and they will need to fill some ranks since there is a nationwide shortage of primary care physicians.  A part of the PCMH design is to have everyone in the office operating at the top of her/his license or skill set.

We were also blessed to bring on a new Certified Medical Assistant, Kweisi (pronounced kwa-eee-suh), who joined the staff in early May.  Kweisi is organized, skilled, and eager to assist our patients.  She has been a much-needed addition to the practice after Samantha's departure in January.  Erica has remained a dedicated and steady staffmember, helping countless patients with countless concerns, and almost never complaining even in the midst of a crisis.

In addition, more help arrived in the form of Wavelength MSO, a company that will be working with our practice and with eClinicalWorks to make sure that we are ready to attest to "Meaningful Use" with Medicare.  This will result in receiving the long-awaited EMR bonus for hard work of the past 5 years.  This will greatly help us, as there are many pieces that still must be put into place this year.  Thankfully, those pieces will also be of great benefit to patient care and will help us achieve our PCMH transformation as well.

I am fast at work, putting together a letter that will go out to the entire practice, highlighting features of our PCMH program and giving patients an opportunity to opt out if they wish.  Of course, we are hoping that everyone will participate, because it is going to be great for patient care.  Having all of these projects has been like an extra job, pretty much since January.  It is almost like starting the practice all over again.  That has me plum tuckered, at times, though the hope of a better future for primary care does drive me onward.  I will be graced with a vacation to Italy soon and then will arrive back on July 5th, exactly five years since the practice started up, ready to implement phase II of Green Spring Internal Medicine, LLC.

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