No. 5: Westmed Medical Group

As an early adopter of healthcare technology, Westmed Medical Group, White Plains, N.Y., has implemented comprehensive electronic systems for all medical records and filmless digital X-rays.

Westmed has seen substantial improvements to the quality of patient care, patient safety and operational efficiency, in addition to gaining impressive cost savings. By advancing a new model of streamlined, evidence-based primary care, Westmed has also achieved national recognition from multiple quality organizations.

In 2001, Westmed determined that documenting quality was critical to realizing the practice's organizational vision of providing the highest level of care while ensuring seamless coordination between patients, providers and payers. We outlined specific technology requirements for improving communication among physicians and achieving complete care coordination across offices. A cross-functional team, including four administrative and information technology employees as well as Westmed senior management, identified a hybrid practice management, or PM, and electronic medical-record system as the best fit for current and anticipated future needs. The system went live in September 2002, six weeks after implementation.

One of the largest challenges facing our field is the pressure to deliver high-quality, evidence-based care that maximizes resources and time. Our physicians see upward of 3,000 patients per day and document each step of care. The PM/EMR solution has allowed us to improve efficiency by redefining workflows. It isolates preparatory tasks that nonphysician staff members can manage and allows report entry and signature in as few as 15 minutes.

As a result, patient visits are more meaningful and productive. The system more than paid for itself in the first year by reducing the number of people who handled paper—from 23 full-time employees to six. In five years, we cut more than $6 million out of our annual costs.

At Westmed, patients benefit from our team approach to primary care through easy access to specialists and secure coordination of the patient record. Because of this, the National Committee for Quality Assurance certified us in January as a Level 3 patient-centered medical home, recognizing our health professionals often go beyond their roles as primary doctor in coordinating a patient's complete medical needs.

Healthcare technology is the backbone of this coordinated care. The system's consistent, structured data entry approach has also allowed Westmed to participate in numerous quality outcomes reporting initiatives. In 2004, the American Diabetes Association honored us with its prestigious certificate of recognition, and we were certified by the NCQA for its Diabetes Recognition Program.

Four other NCQA recognitions soon followed: for heart/stroke, Physician Practice Connections, physician organization certification in credentialing and recredentialing, and Level 3 patient-centered medical home. It would have been nearly impossible to achieve these NCQA certifications without an advanced EMR in place.

A key aspect of our advanced use of the EMR is providing Westmed physicians with access to comprehensive quality and financial dashboards developed from EMR informatics. On the secure Westmed intranet, physicians view their patients' medical home metrics, which are updated daily. Our clinical metrics are measured against practicewide quality enhancement goals. If physicians see that they are not meeting their goals, they can easily review patient records to identify specific areas for improvement.

“EMR informatics were critical for our patient-centered medical home accomplishment,” says Simeon Schwartz, a physician who is president of Westmed Medical Group.

Westmed has prepared for the changes coming from healthcare reform by continually innovating and improving upon the use of technology. Complementary to our designation as a patient-centered medical home, Westmed recently launched an online patient portal.

In addition to being well-received by patients, the portal functionality prepares Westmed to meet meaningful-use requirements for American Recovery and Reinvestment Act stimulus incentives.

As a result of these preparedness efforts, Westmed expects to receive between $3 million and $4 million in stimulus incentives.

“Although final regulations for accountable care organizations are still likely a year away, we believe that our PM/EMR solution will enable us to demonstrate that we are achieving the clinical and revenue-cycle requirements for meaningful use,” Schwartz says. Westmed plans to fully reinvest stimulus incentives in facilities construction.

Merin Joseph is chief information officer of Westmed Medical Group.