Emphasizing the Patient in a Patient-Centered Medical Home

June 15, 2012
Christopher Beal, D.O. , a member of a small, independently owned physician group practice in St. John’s, Mich., has become an unexpected national advocate for patient engagement. Dr. Beal has not only used a patient portal to improve patient relations, but has made it a vital part of his patient-centered medical home (PCMH). In this exclusive interview, he discusses his successes in this area, remaining challenges, and what’s next.

This is part one of a multi-part series on independent physicians who have invested in, and have had success with, patient engagement.

As a member of a three-man, independently owned physician group practice in St. John’s, Mich., internal medicine specialist Christopher Beal, D.O. is not the obvious choice for someone who would champion the use of patient engagement, or any healthcare IT technology for that matter, on a national scale.

Dr. Beal is not an executive at a well known university medical center or a major healthcare system. Yet despite this, he travels around the country, advocating the use of patient engagement portals and talking with audiences about how it’s a vital part of a provider’s patient-centered medical home (PCMH). 

Those who have heard Beal talk about patient engagement will have likely heard about his success rate, and how in just under eight weeks, 28 percent of his patient population was actively using the patient portal he implemented from Kryptiq (Beaverton, Ore.). They may also hear about how his patient phone calls have been reduced by 30 percent since the portal and how it’s freed up more time to actively care for patients.

Christopher Beal, D.O.

The Path to a Portal

Along with talking about his successes, Beal can talk about how when he started his own practice seven years ago, he made an investment out of the gate in an EMR: Centricity from GE Healthcare (Waukesha, Wis.). He made this investment knowing the role health information systems could play in creating efficient, quality care. It proved to be only the beginning of his efforts.  

“That left me square in the sights of this patient-centered medical home initiative,” Beal says. “I had already built the effort to give good care to my patients, something every doctor prescribes to do. But we were also looking at our data, things like scheduled care for preventative services, diabetic outcomes, measuring ourselves against national benchmarks. It was a small step into the PCMH, but it was through that structure that I was able to connect to my patients through a patient portal.”

Along with investing in the integrated portal, Beal says he has created a PCMH by ePrescribing and upgrading his platforms. ePrescribing, through the widely-used Surescripts (Arlington, Va.) network, allows for better coordination and hand-offs between providers, he says. 

“What’s been unique is going to a small-town, setting up my practice here, I function in multiple roles here, I wear multiple hats in that chain of command,” Beal says. “I get sensitive to those issues when I get poor hand-offs because it makes my job difficult.” Successful coordination, he notes, can prevent readmissions, which can increase savings for the healthcare system.

PCMH Ingredients

The portal, which is sold by GE Healthcare and developed by Kryptiq, is actually a part of Beal’s EMR. This integration is one of the main ingredients to his patient engagement success, he says. This is because it avoids having to create multiple entries, which in turn could lead to processing errors. Lawsuits, he notes, come out of inaccurate communication. In addition, he says, the portal has been adopted by his patients because of the trusted relationship he has cultivated with them. “They sense we are making sure they are the number one priority,” he says. 

Initially they were hesitant, but that changed once Beal made it clear that the physician group was looking to empower them. “Once they realized they were part of the process, their buy-in was huge,” he notes. He even got patients past security concerns, noting the web-based portal, was dually authenticated and secure, according to federal guidelines.

Still, it hasn’t been all easy going. While the PCMH model has improved things, Beal says there is still the challenge of getting patients to continually use the portal after they leave his office. He says the patient engagement thresholds put in place by the Centers for Medicare and Medicaid Services (CMS) for meaningful use Stage 2 concern him for this reason.

“It’s going to take a committed staff to help push that because once the patients have left, it’s very hard,” Beal says, noting his practice spends a lot of time tracking why certain patients haven’t followed up.

Looking Beyond Michigan

Beal’s ambitions for this kind of healthcare delivery model are located well beyond his corner in the State of Michigan. He looks to continue to advocate for patient engagement, PCMH, and all of the technology that makes this possible on a national scale. He says he has all but one month reserved for speaking engagements this year.

Beal would especially like to teach and transform older doctors, who are part of smaller practices like his own, and are more set in their own culture. “Those are the doctors that are having the biggest trouble with this,” he says. “I love training new residents, when they come to my clinic. I only need an hour to show them the basics. But for those doctors who have been at it a long time, it takes a longer time.”

According to Beal, he has already had a few “wins” in this area, taking doctors who weren’t adept, holding their hands in some areas, and pushing them along in others. Many others, he notes, worry about the return on investment (ROI). For him, the ROI can’t be measured simply by dollars and cents. Instead, he says it can be measured by the fact his investments into a PCMH, have allowed him to spend a more meaningful 15 minutes with his patients.

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