White River Family Practice (WRFP) - Davies Ambulatory Award

White River Family Practice LogoWhite River Family Practice is staffed with six family physicians, three family nurse-practitioners (ARNP’s), and a support staff of 14. The practice provides care to approximately 10,000 patients most of whom reside in surrounding communities in Vermont and New Hampshire.  

Our mission is to “provide high quality, state-of-the-art primary medical care to our community of patients with compassion, professionalism, and excellent communication.”

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Return on Investment

White River Family Practice, an ambulatory independent primary care practice in northern New England, implemented an electronic health record (EHR) in 2010. Funding for this endeavor was obtained through a combination of grants, operating income, and pay-for-performance incentive monies.

EHR implementation has been extraordinarily successful with demonstrable improvements in practice finances and quality care, assisting WRFP to certify as a Patient Centered Medical Home (PCMH) and optimally position the practice to participate in Accountable Care Organizations (ACO’s) as well as other potential healthcare reforms.

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Clinical Value

This Case Study outlines important aspects of our transformation and initial EHR application leading to sustained improvement in the value of the clinical care provided to our patients around four identified priority care elements; our transformation has also contributed significantly to WRFP’s certification as a Level III Patient Centered Medical Home.

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Clinical Dashboard & Analytics

Using registry output from the EHR, the practice would develop dashboards of care provided to entire populations of similar patients both in health maintenance and chronic disease management, and use these displays to monitor the effectiveness of any improvement project.

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Population Management

WRFP installed an integrated electronic health record (EHR) system in 2010. Following initial training and system configuration, WRFP began using the EHR to systematically improve our provision of four priority primary clinical care elements as detailed in our Clinical Value core case study. Our practice then applied our EHR to improve the healthcare of defined populations of patients with chronic disease and enable selective recall of patients who do not meet certain metrics of chronic disease management for more intensive focused care.

Using a combination of alerts, clinical decision support, redesigned patient workflows, standing orders, and routine registry searches for population care surveillance, the practice has achieved measurable improvement in both processes of care and patient outcomes for those patients with diabetes mellitus and/or asthma.

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