How a Misdiagnosis Led to Innovation

June 24, 2013
During last week’s Care Innovations Summit, sponsored by the Centers for Medicare & Medicaid Services, I was intrigued by one presentation in particular, one by Christopher Chen, M.D., CEO of ChenMed during the Care Delivery/Primary Care Innovation Panel. A lot of what Dr. Chen said seemed intuitive, providing care teams for a well-defined population. And his company’s approach to technology has many applications beyond his four walls.
During last week’s Care Innovations Summit, sponsored by the Centers for Medicare & Medicaid Services, I was intrigued by one presentation in particular, one by Christopher Chen, M.D., CEO of ChenMed during the Care Delivery/Primary Care Innovation Panel. A lot of what Dr. Chen said seemed intuitive, providing care teams for a well-defined population. And his company’s approach to technology has many applications beyond his four walls.

ChenMed had a very personal start, being founded by Dr. Chen’s father, Dr. Jenling James Chen, after the elder Chen was diagnosed with cancer and given two months to live. That prognosis turned out to actually be a misdiagnosis, and the cancer was treatable, with Dr. Chen making a full recovery. This experience led the Chen family on a mission to set up a “compassionate physician-led culture” that would be accountable for patients’ health outcomes.  ChenMed has set up Chen Medical Centers in Florida and in Virginia.

ChenMed focuses on the moderate-to low-income senior population, taking on a full global risk model instead of the traditional fee-for-service set-up. The three tenets of the ChenMed care model:
1)    Invest in patients on front-end to be more cost effective
2)    Completely redesign physician culture to be collaborative
3)    Support with technology and use IT help to scale: “end-to-end technology built to enable the model, not a model built around technology”

Part of the ChenMed model is that the medical center is a one-stop shop that enhances care coordination and provides convenience for patients. There are both onsite specialists and supportive services, like pharmacy, diagnostic testing, and dental. For patients without access to transport, buses are provided for them to and from their appointments. Panel size is capped to between 350 to 450 patients per internist, and patient care is reviewed three times a week by a physician group. A part of this physician collaboration involves “bad outcome meetings,” used to provide transparency and learnings. Among ChenMed’s accomplishments are lower hospital admission and readmission rates for its patient population, as well as a reduction of congestive heart failure (CHF) admissions.

Dr. Chen says that his model of care can be a hotbed for technological innovation, providing a rapid cycle time for solutions to come to market. He says there are 35 custom applications designed to support physicians and staff. For starters, patients have “life cards,” like the French Carte Vitale, with all their medical information stored. ChenMed also has its own proprietary EHR with clinical decision support enhanced with HEDIS measures.

Another interesting technological feature of ChenMed is its robotic digitized pharmacy replacement solution. When patients don’t pick up their medication, the solution will deliver the prescriptions to patient. iPad apps are used to educate patients on their medications as well.




 

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