A team-based approach designed to transform the primary care experience
Current health care trends reveal an increasing number of primary care physicians and teams experiencing burnout, making it harder for patients to access quality health care. Rising health care costs, performance-based reimbursement, and doing more with less all affect patient care and provider satisfaction.
What if there were a way to deliver primary care that is more affordable, accessible and compassionate, while also increasing provider satisfaction, at the same time? The innovation team at Mercy Health believes there is, and they have put their research into action in its new Mercy Health Physician Partners Innovative Primary Care office, which opened on January 2, 2018, on Grand Rapids’ West Side.
Housed in the historic American Seating Building, 801 Broadway, NW, its high ceilings and exposed brick walls hint at a time when the location powered area business. Now, the space offers a powerful promise to what primary health care can and is meant to be — a personalized experience with a team-based approach, with the flexibility to adapt, expand and customize to a patient’s current needs while optimizing healthy outcomes.
This new primary care model is being spearheaded by the Mercy Health innovation team, including primary care physicians Fred Reyelts, MD, and Mary Kline, MD. They are supported by an experienced team of clinicians — Megan Yee, MD; Kristi Dzingle, PA-C; Jerry Miklosi, PA-C; and Renee Sirois, NP, — who will work collaboratively to deliver high quality care using evidence-based practices.
“What makes Mercy Health Physician Partners Innovative Primary Care different — not only from other practices but other health systems — is our comprehensive approach based on years of research and design,” said Reyelts, co-lead physician at Mercy Health Physician Partners Innovative Primary Care. “It’s more than cost-effective measures; it’s a model that is intent on creating a personalized, compassionate experience — for both the patient and the provider. This while continuing our mission to support underserved communities and being a healing, transforming presence in the communities we serve.”
Considered a “pilot” site, this new approach to care delivery will be tested and refined, with the goal of eventually scaling various aspects of its innovations across West Michigan and throughout Trinity Health nationwide. The patient base at the new office is representative of other urban areas in the United States where Trinity Health has a presence, making it an ideal test site.
“The beauty of this model is that it doesn’t have to be duplicated in its entirety,” Reyelts added. “Other Mercy Health providers can observe our processes and implement selected aspects of our model in their current offices, as appropriate.”
What the Research Shows…
Team-based care means more patients and more time. With the right resources and an expanded team of clinical care managers, population health and triage nurses, and medical assistants, the physicians can manage a larger patient base. By expanding the role of all care team members so that their licensures, experiences and abilities are optimized, the providers can focus their time and attention where a higher level of expertise is needed.
Patients may notice that there are more medical assistants doing both direct work (rooming patients) and indirect work (chart preparation), which will keep the office flow going while reducing wait times. When fully staffed, the care team will include pharmacists, additional clinical care managers, health coaches, community health workers, behavioral specialists and nutritionists. While these team members can serve patients onsite, the new facility is also built with consultations for patients via virtual visits in mind.
Team-based care allows more focused attention on better outcomes. In this new team-based model, the physician focuses more on controlling chronic disease, providing guidance about standards of care, and seeing acute patients.
“In the old model, I spent only one-third of my time doing what I do best — seeing people with difficult disease processes or multiple comorbidities to manage,” said Reyelts. “Two-thirds of my time I spent doing everything else.”
Kline agrees. In the new model, some patient care and administrative responsibilities are distributed to other qualified team members to help free up time for physicians to handle more severe or complex cases.
“As a provider,” Kline said, “I can actually spend more of my time focused on building a relationship with and caring for my patient and less time on the administrative details.”
Reyelts added, “We will improve both patient care and team satisfaction by allowing team members to work to their highest level of interest, skills/aptitude and certification/licensure.
Example: If one trained MA (medical assistant) enjoys coaching patients about smoking cessation and another trained MA prefers to help educate patients about lifestyle changes to help lower their blood pressure, why not allow them to do what they prefer and are capable of doing? The new model does just that, while also planning efficient ways to reach the largest group of patients at one time.
What Patients Will Notice
- Onsite Comprehensive Lab with Real-Time Results: The onsite lab may be the most significant, time-saving innovation for patients, who will enter the lab directly from the waiting room. Patients will have labs drawn prior to seeing their provider, and most patients will not need to fast prior to having blood drawn.
Labs are drawn and results are available in the electronic health record within 10 minutes, so the provider is able to review and discuss them immediately during the visit. “Especially in the case of an abnormality,” said Reyelts, “the time to discuss the labs is when the patient is face-to-face with the provider.”
- Exam Rooms: In the 13 comfortable exam rooms, patients’ electronic health records are displayed via monitors, plus all of the equipment necessary to take patients’ vitals in private — including a patient’s weight.
- Group Visits: A conference room with state-of-the-art technology for remote access is available to maximize the number of patients who can benefit from education about a specified topic.
Here, a nutritionist may schedule a group visit for diabetic patients, allowing all to receive care and education simultaneously. Studies show that the value of peer interaction in a group session improves patient compliance. Other potential uses for this room include well-child education visits, lactation group visits and advance care directive education.
- Consult Rooms: Equipped with large-screen monitors, five consult rooms are available for one-on-one or one-on-two visits with team members when an exam table is not needed. They offer real-time interactions with Mercy Health’s specialty network either in person or via virtual visits.
Example: Patients who are experiencing depression can have a private, secure session with a psychiatrist via a virtual visit in a consultation room. Patients can have private consultation with a pharmacist for a medication review.
- Team Room: Team members work together in the same space and can discuss cases directly, reducing the need for delayed digital forms of communication. Collaboration is immediate and in person.
- Respite Rooms: These rooms offer a calm environment for team members to take time to regroup after a difficult case, take a lunch break, breastfeed, exercise or regroup before returning to patient care.
Will visits be more expensive?
In-person visits will cost no more than they currently do. Thanks to this new model’s streamlined process, new technology, and focus on keeping patients healthy, out-of-pocket costs may actually be less for patients over time. This MHPP office accepts the same insurance as the other MHPP offices.
In addition, coming soon, through the technology at MHPP Innovative Primary Care, the team will be able to manage some chronic diseases via virtual visits and home monitoring devices.
Example: A patient with high blood pressure pays a $25 copay per office visit for a BP check. The current standard of care says the patient should be seen two to four times per year and have labs drawn twice a year. With home blood pressure monitoring, the patient may not need to go to the office for a checkup, saving the cost of that copay several times a year.
Compassionate, Expert Care for All
MHPP Innovative Primary Care is accepting new patients. Drs. Reyelts and Kline and their team will see a wide range of patients, from pregnant women and young children to young adults and older patients with more complex medical conditions.
For both patients and clinical teams, the team-based approach will improve the quality of personalized care. “We’re always looking for new ways to deliver better care to our patients,” said Reyelts. “With MHPP’s innovative approach to continuously improving the patient and provider experience, now we can.”
Mercy Health Physician Partners Innovative Primary Care Open House: Open to the Public!
Thursday, January 11, 2018