Fremont Family Care, a small primary care practice in Fremont, NE. Just prior to the implementation of their practice-wide EHR, Fremont lost several key physicians. Improved documentation, cost avoidance associated with improved clinical outcomes, and a strong culture of information sharing with the local hospital allowed Fremont to quickly recover on the lost patient load to demonstrate significant return on investment. Quality improvement outcomes included lower hospitalization for pneumonia and improved HgbA1c control in Fremont's patient population, while Fremont also successfully screened and immunized patients at a much higher rate for flu, breast cancer, and colorectal cancer through the utilization of an EHR-enabled workflow that featured use of best practice clinical decision support alerts, analytics, and patient engagement.
In order to determine the outcome associated with the improved process associated with increasing pneumonia vaccination, Fremont Family Care partnered with Fremont Area Medical Center (now Fremont Health) in fiscal year 2013 to track and improve hospitalizations for pneumonia. Fremont Health began to collect data identifying patient admissions and shared admission rates specifically for Fremont Family Care patients. As result of an EHR-enabled initiative to use CDS to improve pneumonia vaccinations, Fremont observed over a 50% decrease in the number of their patients that were hospitalized for pneumonia.
Through improved documentation, real time access to data, improved billing times and cost to collect, and cost avoidance through clinical improvements enabled by Fremont Family Care's EHR, FFC has generated hard return on investment almost doubling the original cost of the EHR to the practice.
As result of using clinical decision support best practice alerts and a new EHR-enabled workflow, Fremont Family Care saw a significant increase in the percentage of patients who had received appropriate preventative care, including doubling the number of at risk patients who received colonoscopies, mammograms, and flu vaccine in a two year time period.
Following the establishment of quality care metrics and implementing the MAQ Dashboard, FFC established a quarterly review process of metrics. These results are shared with each clinical team and across the practice (See figure below). The providers/clinical teams who are outliers are identified. Steps were taken to improve processes, resulting a significant increase in the number of diabetic patients with their hemoglobin A1C under control (<7.)